{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:04:08Z","timestamp":1790600648005,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Consensus on the treatment for severely comminuted calcaneus fractures has yet to be found. This study aims to analyze the functional and radiological short- and medium-term outcomes of displaced calcaneus fractures of type III and IV treated with ORIF, and to identify, if present, the early predictors of unfavorable outcomes. Methods: Thirty-three calcaneal fractures were included, 23 type III and 10 type IV, according to Sanders classification. AOFAS scales for ankle and hindfoot and SF-12 were used. B\u00f6hler and Gissane angles were analyzed before and after surgery. Results: The minimum follow-up was six years. The mean AOFAS score at six months was 16.5 points (24.2 \u00b1 10.8 vs 10.8 \u00b1 9.5; p = 0.03) with better outcomes in patients with Sanders type III fractures. This difference decreased in the subsequent follow-up. Likewise, the mental and physical score of SF-12 had the same trend. Two wound infections and no deep infections were recorded in the Sanders type III fracture group. Instead, in the Sanders type IV group, there were four wound infections and one deep infection. Conclusions: Clinical and radiological outcomes in Sanders Type III and Type IV calcaneus fractures treated with plate and screws were very similar in long-term follow-up. If ORIF provided better short- to medium-term follow-up in Sanders type III fracture, these benefits have been lost in six years. Polytrauma and psychiatric patients showed significantly lower clinical outcomes in long-term follow-up, appearing as the most reliable negative predictors.<\/jats:p>","DOI":"10.3390\/jcm11195660","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T01:51:49Z","timestamp":1664329909000},"page":"5660","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Predictive Factors of Poor Outcome in Sanders Type III and IV Calcaneal Fractures Treated with an Open Reduction and Internal Fixation with Plate: A Medium-Term Follow-Up"],"prefix":"10.3390","volume":"11","author":[{"given":"Luigi","family":"Cianni","sequence":"first","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-9665","authenticated-orcid":false,"given":"Raffaele","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-9536","authenticated-orcid":false,"given":"Tommaso","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Sirgiovanni","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Allergology and Intensive Care Medicine, University of Saarland, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Ragonesi","sequence":"additional","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Maccauro","sequence":"additional","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopedics and Trauma Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Perisano","sequence":"additional","affiliation":[{"name":"Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.foot.2009.05.001","article-title":"The Epidemiology of Calcaneal Fractures","volume":"19","author":"Mitchell","year":"2009","journal-title":"The Foot"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11751-017-0297-3","article-title":"Calcaneal Fractures: Where Are We Now?","volume":"13","author":"Razik","year":"2018","journal-title":"Strateg. 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Foot Ankle Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5660\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:39:31Z","timestamp":1760143171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/19\/5660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,26]]},"references-count":31,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11195660"],"URL":"https:\/\/doi.org\/10.3390\/jcm11195660","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,26]]}}}