Traditional Chinese bone-setting combined with percutaneous screw fixation for comminuted calcaneal fractures: A case report and review of literature.

backgroundComminuted calcaneal fractures present significant treatment challenges. Open reduction and internal fixation carries risks such as infection and skin necrosis, while minimally invasive techniques may compromise reduction stability. Conservative management is generally limited to minimally displaced fractures. Traditional Chinese manual bone-setting has a long history in fracture treatment and is renowned globally for achieving functional reduction. It offers distinct advantages including lower cost, minimal soft tissue trauma, and the avoidance of expensive reduction equipment or internal fixation materials. CASE SUMMARY: A 60-year-old female presented with left foot pain and limited mobility following a fall. Computed tomography scan revealed a Sanders type IV calcaneal fracture with a Böhler angle of 0°. A standardized, stepwise Traditional Chinese manual bone-setting was initially performed, followed by percutaneous screw fixation through several mini-incisions after satisfactory alignment was confirmed under fluoroscopy. The Visual Analog Scale score decreased from 5 on postoperative day 1 to 3 by day 3. The American Orthopaedic Foot and Ankle Society score improved from 73 at 6 weeks to 90 at 3 months, indicating rapid functional recovery and high patient satisfaction. At 7 months postoperatively, the American Orthopaedic Foot and Ankle Society score reached 95, prompting removal of internal fixation. At the 6-year follow-up, reduction remained well maintained, with the Böhler angle preserved at 22°.

conclusionThe combination of Traditional Chinese manual bone-setting and percutaneous screw fixation achieved satisfactory functional reduction for comminuted calcaneal fractures.