Study on Functional Outcome of Sanders Type III and IV Fracture Calcaneum treated by Minimally Invasive Screw Fixation

Context: Managing calcaneal fractures remains a perplexing challenge for many surgeons due to differing opinions and complexities, often leading to apprehension about treatment approaches. Minimally invasive screw fixation (MISF) offers a trade-off between open plate fixation and nonoperative management. Aims: The study aims to assess the functional outcome after treating calcaneal fractures with MISF. Settings and Design: Department of Orthopaedics, Government Medical College, Kottayam. Materials and Methods: The study was conducted among 38 patients with Sanders type III and IV calcaneal fractures who underwent MISF with percutaneous cannulated cancellous screws. They were followed up for 1 year, and functional outcome was assessed using the Maryland Foot Score (MFS). Statistical Analysis Used: The Friedman test was used for comparing the mean scores of MFS at follow-up at 2, 6, and 12 months. Preoperative factors associated with a favorable MFS were assessed with the Pearson’s Chi-square test. The level of significance was fixed at 5% with a confidence interval of 95%. Results: 47.4% and 52.6% of patients had type III and type IV Sanders calcaneal fractures, respectively. Patients had a mean MFS of 57% at the 2 nd month, which improved to 79.7% and 88%, respectively, at 6 and 12 months ( P < 0.001), with significant radiological improvement in Bohler’s angle ( P < 0.001) and angle of Gissane ( P < 0.001) postoperatively. One-year follow-up of all patients showed good-to-excellent outcomes with healthy soft tissue without long-term complications. Conclusions: MISF yielded improving outcomes, with most patients recovering by 1 year, without complications or fixation failure.