SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Percutaneous screw osteosynthesis for the treatment of intra-articular displaced calcaneus fractures.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
purposeThis systematic review investigates how percutaneous screw osteosynthesis for the treatment of intra-articular displaced calcaneus fractures differs from open reduction and internal fixation (ORIF).
methodsRandomized controlled trials and controlled clinical trials investigating adults with closed intra-articular displaced calcaneus fracture (Sanders type II - IV) treated with percutaneous screw osteosynthesis or ORIF were included. Severe vascular and neurological diseases or polytrauma patients were excluded. On January 29, 2024, five databases and two trial registries were searched. The Risk of Bias Tool of Cochrane was used. The protocol was registered on PROSPERO (CRD42021244695).
resultsFive studies with 654 participants (682 calcaneus fractures) were included. The risk of bias was moderate to high. None of the single studies found a significant difference regarding severe complications. However, meta-analysis revealed a lower risk for the percutaneous screw osteosynthesis group compared to ORIF (relative risk (RR) 0.40 (95% Confidence Interval [0.17; 0.92]; I² = 0%; p = 0.03). One study showed less pain in the percutaneous screw osteosynthesis group up to 4 weeks postoperatively. No study assessed health-related quality of life.
conclusionPercutaneous screw osteosynthesis in intra-articular displaced calcaneus fractures might be beneficial to ORIF in terms of minor and severe complications, and pain at four weeks. Percutaneous screw osteosynthesis could be an additional, less invasive treatment option, depending on the complexity of the injury. However, studies with larger sample sizes are needed to confirm these results and explore long-term complications.
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