{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:05:27Z","timestamp":1790057127411,"version":"4.0.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"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. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Calcaneal tuberosity avulsion fractures are primarily caused by intense traction of the Achilles tendon. Clinical treatment remains challenging, with a high failure rate. Current research mainly focuses on injury mechanisms, retrospective analyses, and case discussions, while biomechanical experimental evidence is still lacking. Therefore, selecting the most appropriate internal fixation method to achieve satisfactory outcomes remains a key issue to be addressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed finite element analysis to compare the fixation efficacy of five internal fixation techniques for type II calcaneal tuberosity fractures. Clinical cases involving treatment failure were retrospectively reviewed to explore the management process and underlying causes, aiming to provide a mechanical basis and reference for future clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 180\u00b0 annular plate was identified as the optimal fixation method for treating such fractures. In addition, the Achilles tendon tension band technique significantly reduced the risk of treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For type II calcaneal tuberosity avulsion fractures, the 180\u00b0 annular plate provides the best biomechanical performance, while the Achilles tendon tension band technique also effectively lowers the failure rate. These findings offer valuable mechanical evidence to guide clinical decision-making and improve surgical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1765823","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:40:49Z","timestamp":1790055649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical case analysis and finite element analysis of Beavis type II avulsion fractures of the calcaneal tuberosity"],"prefix":"10.3389","volume":"13","author":[{"given":"Changpeng","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Orthopedics, China-Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faxin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, China-Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyao","family":"Wang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Second Affiliated Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, China-Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.fas.2019.07.002","article-title":"Percutaneous arthroscopic calcaneal osteosynthesis for displaced intra-articular calcaneal fractures: systematic review and surgical technique","volume":"26","author":"Marouby","year":"2020","journal-title":"Foot Ankle Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1053\/j.jfas.2014.03.018","article-title":"Evidence-based rationale for percutaneous fixation technique of displaced intra-articular calcaneal fractures: a systematic review of clinical outcomes","volume":"53","author":"Wallin","year":"2014","journal-title":"J Foot Ankle Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1007\/s10140-025-02402-w","article-title":"Avulsion fracture of the posterior calcaneal tuberosity: anatomy, injury patterns, and an approach to management","volume":"32","author":"White","year":"2025","journal-title":"Emerg Radiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"101096","DOI":"10.1016\/j.tcr.2024.101096","article-title":"A suspensory fixation technique for calcaneal tuberosity avulsion fractures using the TightRope attachable button system","volume":"54","author":"Nair","year":"2024","journal-title":"Trauma Case Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"134","DOI":"10.4055\/cios.2012.4.2.134","article-title":"Avulsion fracture of the calcaneal tuberosity: classification and its characteristics","volume":"4","author":"Lee","year":"2012","journal-title":"Clin Orthop Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOSGlobal-D-21-00172","article-title":"Avulsion fractures of the calcaneal tuberosity: a single-center review of outcomes and complications","volume":"5","author":"Doany","year":"2021","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1177\/1938640014548323","article-title":"Calcaneal avulsion fractures: a case series of 33 patients describing prognostic factors and outcomes","volume":"8","author":"Gitajn","year":"2015","journal-title":"Foot Ankle Spec"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1007\/s00402-007-0517-2","article-title":"Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome","volume":"128","author":"Schepers","year":"2008","journal-title":"Arch Orthop Trauma Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1186\/s13018-025-06385-9","article-title":"Clinical outcomes of nice knot combined with cannulated screws for Beavis type II posterior calcaneal tuberosity avulsion fractures in osteoporotic elderly patients","volume":"20","author":"Lu","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1053\/j.jfas.2017.07.016","article-title":"Avulsion fracture of the calcaneal tuberosity","volume":"57","author":"Rauer","year":"2018","journal-title":"Case Report and Literature Review. 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