{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:08:55Z","timestamp":1784182135562,"version":"3.55.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Minimally invasive surgical treatment is increasingly favored for intra-articular displaced calcaneal fractures with a high risk of soft tissue complications. The calcaneus is the largest tarsal bone in the foot and plays a critical role in weight-bearing and gait mechanics; displaced fractures often result in significant functional impairment. Sanders Type II fractures, characterized by a single major fracture line that divides the posterior articular surface into two major bone fragments, are one of the most common subtypes and present a therapeutic challenge in balancing mechanical stability with soft tissue preservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A finite element model of Sanders Type II calcaneal fractures was established to compare five fixation methods under physiological tendon loading: (1) a periosteal locking plate, (2) four hollow screws, (3) four K-wires placed along the screw trajectory, (4) two intra-articular K-wires combined with two standard K-wires, and (5) six K-wires placed at dispersed locations. Outcome measures included maximum fragment displacement, implant-induced bone stress, and implant stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rigid internal fixation (hollow screws) provided the best initial stability and the least displacement of the bone fragments. A key finding was that under the most severe static loading condition (dorsiflexion with maximum Achilles tendon force), the maximum fragment displacement for all K-wire configurations (\u22640.103 mm) was below both the clinically reported acceptable threshold (\u22640.5 mm) and the safe healing range (&amp;lt;1 mm), indicating sufficient initial healing stability. Furthermore, K-wires generated significantly lower stress on the bone than the plate, while cannulated screw fixation carried the lowest risk of implant failure. Based on extended observations from clinical literature, K-wire fixation offers potential advantages including a minimally invasive approach, flexible handling, low implant burden, and the possibility of outpatient removal to avoid secondary surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although rigid implants are biomechanically superior, K-wire fixation provides clinically acceptable initial stability and, combined with its minimally invasive characteristics, represents an attractive alternative. The choice of fixation method requires a comprehensive consideration of individual patient factors (such as bone quality and functional demands) and the overall treatment strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1857728","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:37:40Z","timestamp":1784180260000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical comparison of minimally invasive fixation for sanders II calcaneal fractures: a multi-position finite element study from rigid internal fixation to elastic kirschner wire configuration"],"prefix":"10.3389","volume":"14","author":[{"given":"Zulong","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University (The First People\u2019s Hospital of Hefei), Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University (The First People\u2019s Hospital of Hefei), Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingchao","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University (The First People\u2019s Hospital of Hefei), Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rende","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University (The First People\u2019s Hospital of Hefei), Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B3","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1177\/03635465241260054","article-title":"The biomechanical, biochemical, and morphological properties of 19 human cadaveric lower limb tendons and ligaments: an open-access data set","volume":"52","author":"Ashton","year":"2024","journal-title":"Am. 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