{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T09:09:47Z","timestamp":1776244187919,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"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: Displaced intra-articular calcaneal fractures are difficult to treat due to their complex anatomy and the high risk of soft-tissue complications. Although open reduction and internal fixation (ORIF) enables accurate anatomical reconstruction, it can be associated with substantial wound morbidity. Minimally invasive techniques have been developed to mitigate these risks. This study aims to describe a modified external fixation technique and report its clinical and radiographic outcomes in consecutive cases of patients with displaced intra-articular calcaneal fractures, with a minimum follow-up period of one year. Methods: The surgical technique is described in detail. The technique was evaluated by analyzing the treatment results in a case series of 17 patients. The time from injury to surgery, radiographic parameters (B\u00f6hler\u2019s angle and time to union) and clinical outcomes were recorded and analyzed, as were complication rates. The minimum follow-up period was 12 months. Results: Surgical reconstruction was performed at a mean of three days (range 1\u20136 days; SD 1.5) after injury. Preoperative radiographic parameters showed significant deformity, with calcaneal morphology restored at follow-up. At 12 months, the mean B\u00f6hler angle had increased to 27.8\u00b0, and all fractures had achieved radiographic union. Functional outcomes improved progressively over time, with increases in both the AOFAS and SF-12 P scores. One complication was observed: K-wire displacement requiring conversion to ORIF in a psychiatric patient. Conclusions: The proposed technique facilitates early surgical treatment and the satisfactory restoration of calcaneal morphology with no soft-tissue complications. It appears to be safe and effective in selected patients. A longer follow-up will provide further insight into long-term outcomes, such as subtalar osteoarthritis.<\/jats:p>","DOI":"10.3390\/jcm15082991","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:11:18Z","timestamp":1776240678000},"page":"2991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Modified Design External Fixator System for Calcaneal Fractures: Surgical Technique and an Observational Single-Center Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-9574","authenticated-orcid":false,"given":"Michela","family":"Saracco","sequence":"first","affiliation":[{"name":"Department of Public Health, Division of Orthopedic and Traumatology, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"},{"name":"CEINGE Advanced Biotechnology, 80145 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"De Negri","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Orthopedic and Traumatology, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Pagano","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Orthopedic and Traumatology, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Orthopedic and Traumatology, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-5124","authenticated-orcid":false,"given":"Massimo","family":"Mariconda","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Orthopedic and Traumatology, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1016\/j.injury.2021.05.013","article-title":"Psychological dysfunction associated with calcaneal fractures","volume":"52","author":"Walsh","year":"2021","journal-title":"Injury"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.fas.2024.01.006","article-title":"Postoperative complications after displaced intra-articular calcaneal fracture operations","volume":"30","author":"Lappalainen","year":"2024","journal-title":"Foot Ankle Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.injury.2020.09.010","article-title":"Sanders classification of calcaneal fractures in CT images with deep learning and differential data augmentation techniques","volume":"52","author":"Lai","year":"2021","journal-title":"Injury"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s00590-021-03115-9","article-title":"Plate fixation through the lateral extensile approach versus cannulated screw fixation through the sinus tarsi approach for calcaneal fracture: A multicenter, propensity score-matched TRON study","volume":"32","author":"Sugimoto","year":"2022","journal-title":"Eur. 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