{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:05:12Z","timestamp":1774274712471,"version":"3.50.1"},"reference-count":72,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Calcaneal fractures are complex injuries frequently associated with significant soft tissue damage and a high risk of post-operative complications, particularly infection. Despite advances in surgical techniques, infectious complications remain a major cause of morbidity and can severely compromise functional outcomes. The aim of this systematic review was to analyze the incidence, management strategies, and clinical impact of infectious complications following surgical treatment of calcaneal fractures. Methods: A systematic literature search was conducted in MEDLINE, Scopus, and Web of Science in accordance with PRISMA guidelines, including studies published up to May 2025. Randomized controlled trials and prospective and retrospective cohort studies involving adult patients surgically treated for calcaneal fractures and reporting post-operative infectious outcomes were included. Data extraction focused on patient demographics, fracture characteristics, surgical techniques, infection rates, microbiological findings, management strategies, complications, and functional outcomes. Methodological quality and risk of bias were assessed using the MINORS score. Due to substantial heterogeneity, results were synthesized descriptively. Results: Forty studies met the inclusion criteria, encompassing 5343 patients and 4638 surgically treated calcaneal fractures. Displaced intra-articular fractures predominated, with Sanders type II and III accounting for 79.8% of classified fractures, while Sanders type IV fractures represented 20.2% and were associated with higher complication rates. The overall post-operative infection rate was 9.4%, including 6.3% superficial surgical site infections and 3.0% deep infections. Open fractures accounted for 7.5% of reported cases and demonstrated markedly higher infection rates than closed injuries. Deep infections frequently required implant removal (62%), prolonged intravenous antibiotic therapy (100%), and additional surgical procedures (71%). Staphylococcus aureus, including methicillin-resistant strains, was the most commonly isolated pathogen. Functional outcomes were consistently worse in patients who developed infections. Conclusions: Infectious complications remain a clinically significant problem following surgical treatment of calcaneal fractures, particularly in severe fracture patterns, open injuries, and patients with relevant comorbidities. Deep infections are associated with substantial morbidity and inferior functional outcomes. Optimization of patient-related risk factors, careful surgical planning, and the selective use of minimally invasive approaches may help reduce infection risk. Further high-quality prospective studies with standardized outcome measures are needed to define optimal management strategies.<\/jats:p>","DOI":"10.3390\/life16030528","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:07:06Z","timestamp":1774271226000},"page":"528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment\u00a0Options in Managing Infections Following Calcaneal Fractures: A Systematic Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9565-6691","authenticated-orcid":false,"given":"Giacomo","family":"Capece","sequence":"first","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Pellegrini Hospital, 80134 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-7411","authenticated-orcid":false,"given":"Chiara","family":"Comisi","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Bocchino","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7059-935X","authenticated-orcid":false,"given":"Rocco Maria","family":"Comodo","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7765-2666","authenticated-orcid":false,"given":"Virginia","family":"Cinelli","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Moretti","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-9536","authenticated-orcid":false,"given":"Tommaso","family":"Greco","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Department of Life Sciences, Health, and Healthcare Professions, Link Campus University, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Maccauro","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Perisano","sequence":"additional","affiliation":[{"name":"Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy"},{"name":"Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref_1","unstructured":"Davis, D., Seaman, T.J., and Newton, E.J. (2023). Calcaneus fractures. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1016\/j.injury.2012.05.011","article-title":"Management of calcaneal fractures: What have we learnt over the years?","volume":"43","author":"Guerado","year":"2012","journal-title":"Injury"},{"key":"ref_3","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":"Foot"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.fas.2024.11.004","article-title":"Calcaneus fractures, epidemiology and treatment\u2014Data on 3 949 fractures from the Swedish Fracture Register","volume":"31","author":"Rubenson","year":"2025","journal-title":"Foot Ankle Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hall, R.L., and Shereff, M.J. (1993). Anatomy of the calcaneus. Clin. Orthop. Relat. Res., 27\u201335.","DOI":"10.1097\/00003086-199305000-00004"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1053\/j.jfas.2019.08.007","article-title":"Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis","volume":"59","author":"Seat","year":"2020","journal-title":"J. Foot Ankle Surg. Off. Publ. Am. Coll. Foot Ankle Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.foot.2017.10.001","article-title":"Successful treatment of infected wound dehiscence after minimally invasive locking-plate osteosynthesis of tibial pilon and calcaneal fractures by plate preservation, surgical debridement and antibiotics","volume":"33","author":"Ieropoli","year":"2017","journal-title":"Foot"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.fas.2018.12.002","article-title":"Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: A retrospective cross-sectional study with final follow up at skeletal maturity","volume":"26","author":"Indino","year":"2020","journal-title":"Foot Ankle Surg. Off. J. Eur. Soc. Foot Ankle Surg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Leigheb, M., Codori, F., Samaila, E.M., Mazzotti, A., Villafa\u00f1e, J.H., Bosetti, M., Ceccarini, P., Cochis, A., Daou, F., and Ronga, M. (2023). Current Concepts about Calcaneal Fracture Management: A Review of Metanalysis and Systematic Reviews. Appl. Sci., 13.","DOI":"10.20944\/preprints202308.0813.v1"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ijsu.2017.12.034","article-title":"Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: A meta-analysis of randomized controlled trials","volume":"50","author":"Zeng","year":"2018","journal-title":"Int. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24730114221101609","DOI":"10.1177\/24730114221101609","article-title":"Systematic Review of Operative vs Nonoperative Treatment of Displaced Intraarticular Calcaneal Fractures","volume":"7","author":"Selim","year":"2022","journal-title":"Foot Ankle Orthop."},{"key":"ref_12","first-page":"161","article-title":"Operative versus Non operative treatment of displaced intraarticular fracture of calcaneum: A meta-analysis of randomized controlled trials","volume":"83","author":"Meena","year":"2017","journal-title":"Acta Orthop. Belg"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/os.12913","article-title":"Lateral Fracture-Dislocation of the Calcaneus: Case Reports and a Systematic Review","volume":"13","author":"Zhang","year":"2021","journal-title":"Orthop. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Barini, M., Zagaria, D., Licandro, D., Pansini, S., Airoldi, C., Leigheb, M., and Carriero, A. (2021). Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis. Diagnostics, 11.","DOI":"10.3390\/diagnostics11101782"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/bmb\/ldp030","article-title":"Management of calcaneal fractures: Systematic review of randomized trials","volume":"92","author":"Gougoulias","year":"2009","journal-title":"Br. Med. Bull."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.fas.2015.10.003","article-title":"Current management options for displaced intra-articular calcaneal fractures: Non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review","volume":"22","author":"Sharr","year":"2016","journal-title":"Foot Ankle Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.2106\/00004623-200210000-00001","article-title":"Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: A prospective, randomized, controlled multicenter trial","volume":"84","author":"Buckley","year":"2002","journal-title":"J. Bone Jt. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.2106\/JBJS.H.01475","article-title":"Long-term functional outcomes after operative treatment for intra-articular fractures of the calcaneus","volume":"91","author":"Potter","year":"2009","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1007\/s11999-013-3062-z","article-title":"Severity of injury predicts subsequent function in surgically treated displaced intraarticular calcaneal fractures","volume":"471","author":"Rammelt","year":"2013","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1016\/j.injury.2017.08.015","article-title":"Evaluation and quantification of geographical differences in wound complication rates following the extended lateral approach in displaced intra-articular calcaneal fractures\u2014A systematic review of the literature","volume":"48","author":"Backes","year":"2017","journal-title":"Injury"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am. J. Infect. Control"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.injury.2017.08.040","article-title":"Fracture-related infection: A consensus on definition from an international expert group","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.injury.2016.09.019","article-title":"Infection after fracture fixation: Current surgical and microbiological concepts","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (minors): Development and validation of a new instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/1938640014537301","article-title":"Association Between Smoking and Wound Infection Rates Following Calcaneal Fracture Fixation","volume":"7","author":"Soni","year":"2014","journal-title":"Foot Ankle Spec."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1053\/j.jfas.2021.11.013","article-title":"Low Risk of Wound Complications With Sinus Tarsi Approach for Treatment of Calcaneus Fractures","volume":"61","author":"Wallace","year":"2022","journal-title":"J. Foot Ankle Surg."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Basile, A., Lanzetti, R.M., Giai Via, A., Venditto, T., Spoliti, M., Sessa, P., Tortora, M., and Maffulli, N. (2023). Delayed Surgical Treatment of Displaced Intra-Articular Calcaneal Fractures in Major Trauma Is Safe and Effective. J. Clin. Med., 12.","DOI":"10.3390\/jcm12052039"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"271","DOI":"10.4103\/0019-5413.49388","article-title":"Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications","volume":"43","author":"Rak","year":"2009","journal-title":"Indian J. Orthop."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1186\/s13018-018-1003-y","article-title":"Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study","volume":"13","author":"Wang","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1186\/s13018-024-04975-7","article-title":"Three dimensional analysis of factors affecting the prognosis of calcaneal fractures","volume":"19","author":"Lu","year":"2024","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1053\/j.jfas.2017.08.002","article-title":"The Use of Cryotherapy for the Prevention of Wound Complications in the Treatment of Calcaneal Fractures","volume":"57","author":"Lin","year":"2018","journal-title":"J. Foot Ankle Surg."},{"key":"ref_33","first-page":"18","article-title":"A Simple Surgical Technique of Trans Articular K Wires Fixation Through Sinus Tarsi Approach for Treating Intra Articular Calcaneal Fractures: A Large Case Series","volume":"9","author":"Patil","year":"2023","journal-title":"Trauma Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1302\/0301-620X.92B5.23542","article-title":"Osteosynthesis of displaced intra-articular fractures of the calcaneum: A long-term review of 47 cases","volume":"92","author":"Makki","year":"2010","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0020-1383(01)00024-9","article-title":"The operative management of displaced intra-articular fractures of the calcaneum: A two-centre study using a defined protocol","volume":"32","author":"Tennent","year":"2001","journal-title":"Injury"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/00005131-200304000-00001","article-title":"Complications following management of displaced intra-articular calcaneal fractures: A prospective randomized trial comparing open reduction internal fixation with nonoperative management","volume":"17","author":"Howard","year":"2003","journal-title":"J. Orthop. Trauma"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/145749690509400313","article-title":"Postoperative wound complications after internal fixation of closed calcaneal fractures: A retrospective analysis of 126 consecutive patients with 148 fractures","volume":"94","author":"Koski","year":"2005","journal-title":"Scand. J. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.injury.2013.03.014","article-title":"Open reduction and internal fixation of acute intra-articular displaced calcaneal fractures: A retrospective analysis of surgical timing and infection rates","volume":"44","author":"Ho","year":"2013","journal-title":"Injury"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1177\/1071100713484718","article-title":"Risk Factors for Postoperative Wound Complications of Calcaneal Fractures Following Plate Fixation","volume":"34","author":"Ding","year":"2013","journal-title":"Foot Ankle Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00590-019-02522-3","article-title":"Long-term mortality after internal fixation of calcaneal fractures: A retrospective study","volume":"30","author":"Brewster","year":"2020","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Cianni, L., Vitiello, R., Greco, T., Sirgiovanni, M., Ragonesi, G., Maccauro, G., and Perisano, C. (2022). 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. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195660"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s13018-016-0426-6","article-title":"Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: A comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)","volume":"11","author":"Biz","year":"2016","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"110295","DOI":"10.1016\/j.biopha.2020.110295","article-title":"Calcaneus traction compression with orthopaedic reduction forceps combined with percutaneous minimally invasive treatment of intra-articular calcaneal fractures: An analysis of efficacy","volume":"128","author":"Jianchuan","year":"2020","journal-title":"Biomed. Pharmacother."},{"key":"ref_44","first-page":"355","article-title":"Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate","volume":"16","author":"Jain","year":"2013","journal-title":"Chin. J. Traumatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s12306-018-0549-5","article-title":"Evaluation of long-term postoperative outcomes between mini-open and arthroscopic repair for isolated supraspinatus tears: A retrospective analysis","volume":"102","author":"Vicenti","year":"2018","journal-title":"Musculoskelet. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ma, D., Huang, L., Liu, B., Liu, Z., Xu, X., Liu, J., Chu, T., and Pan, L. (2021). Efficacy of Sinus Tarsal Approach Compared with Conventional L-Shaped Lateral Approach in the Treatment of Calcaneal Fractures: A Meta-Analysis. Front. Surg., 7.","DOI":"10.3389\/fsurg.2020.602053"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1016\/j.injury.2015.06.015","article-title":"Stress fractures of the foot and ankle","volume":"48","author":"Welck","year":"2017","journal-title":"Injury"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3535","DOI":"10.1016\/j.injury.2022.06.037","article-title":"Treatment of displaced intra-articular calcaneal fractures: A single-center experience study with 20 years follow-up","volume":"53","author":"Driessen","year":"2022","journal-title":"Injury"},{"key":"ref_49","first-page":"e28684","article-title":"Minimally Invasive Osteosynthesis of Intraarticular Calcaneus Fracture Augmented by Femoral Head Allograft: A Retrospective Study","volume":"14","author":"Moussa","year":"2022","journal-title":"Cureus"},{"key":"ref_50","unstructured":"Backes, M. (2017). Complications in Calcaneal Fracture Surgery and Implant Removal. [Ph.D. Thesis, University of Amsterdam]."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"857","DOI":"10.12669\/pjms.324.10225","article-title":"Complications in operative fixation of calcaneal fractures","volume":"32","author":"Li","year":"2016","journal-title":"Pak. J. Med. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Schindler, C., Schirm, A., Zdravkovic, V., Potocnik, P., Jost, B., and Toepfer, A. (2021). Outcomes of intra-articular calcaneal fractures: Surgical treatment of 114 consecutive cases at a maximum care trauma center. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04088-w"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13037-015-0065-6","article-title":"High incidence of post-operative infection after \u2018sinus tarsi\u2019 approach for treatment of intra-articular fractures of the calcaneus: A 5 year experience in an academic level one trauma center","volume":"9","author":"Rawicki","year":"2015","journal-title":"Patient Saf. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/os.12160","article-title":"Sanders II type calcaneal fractures: A retrospective trial of percutaneous versus operative treatment","volume":"7","author":"Wang","year":"2015","journal-title":"Orthop. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Fitschen-Oestern, S., Lippross, S., Lefering, R., Besch, L., Kl\u00fcter, T., Schenzer-Hoffmann, E., Seekamp, A., and Dgu, T. (2019). Missed foot fractures in multiple trauma patients. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2501-8"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Sypien, P., and Grzelecki, D. (2025). A Mid-Term Result of the Treatment of Intra-Articular Calcaneal Fractures with the Use of Intramedullary Nailing. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041369"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1186\/s13018-019-1405-5","article-title":"Steinmann pin retractor-assisted reduction with circle plate fixation via sinus tarsi approach for intra-articular calcaneal fractures: A retrospective cohort study","volume":"14","author":"Zhao","year":"2019","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1016\/j.injury.2017.08.027","article-title":"Outcome following osteosynthesis or primary arthrodesis of calcaneal fractures: A cross-sectional cohort study","volume":"48","author":"Dingemans","year":"2017","journal-title":"Injury"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1053\/j.jfas.2020.06.017","article-title":"Outcome of Minimally Invasive Osteosynthesis for Displaced Intra-articular Calcaneal Fractures Using Cannulated Screws: A Prospective Case Series","volume":"60","author":"Shams","year":"2021","journal-title":"J. Foot Ankle Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s10195-013-0246-y","article-title":"Surgical treatment of displaced intra-articular calcaneal fractures: Is bone grafting necessary?","volume":"14","author":"Singh","year":"2013","journal-title":"J. Orthop. Traumatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e14046","DOI":"10.1016\/j.heliyon.2023.e14046","article-title":"Fixation of intra-articular calcaneal fractures: A comparative study of the postoperative outcome between HA\/PPLA screws and locking plates","volume":"9","author":"Usami","year":"2023","journal-title":"Heliyon"},{"key":"ref_62","first-page":"469","article-title":"Operative treatment algorithm for intra-articular calcaneal fractures","volume":"84","author":"Popelka","year":"2018","journal-title":"Acta Orthop. Belg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1007\/s00590-023-03829-y","article-title":"The role of patient positioning in surgical fixation of the calcaneus fractures using the lateral extensile approach","volume":"34","author":"Kayali","year":"2024","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"457","DOI":"10.55095\/achot2008\/085","article-title":"Strednedob\u00e9 zkusenosti s l\u00e9cbou zlomenin patn\u00ed kosti otevrenou repozic\u00ed a vnitrn\u00ed fixac\u00ed kalkane\u00e1rn\u00ed LCP z rozs\u00edren\u00e9ho later\u00e1ln\u00edho pr\u00edstupu [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach]","volume":"75","author":"Zeman","year":"2008","journal-title":"Acta Chir. Orthop. Traumatol. Cech."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Capece, G., Di Gialleonardo, E., Comisi, C., Bocchino, G., Cinelli, V., Mascio, A., Fulchignoni, C., Greco, T., Maccauro, G., and Perisano, C. (2025). Treatment Options of Prosthetic Joint Infections Following Total Ankle Arthroplasty: A Systematic Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14030718"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Caravelli, S., Gardini, G., Pungetti, C., Gentile, P., Perisano, C., Greco, T., Rinaldi, V.G., Marcheggiani Muccioli, G.M., Tigani, D., and Mosca, M. (2022). Intra-Articular Calcaneal Fractures: Comparison between Mini-Invasive Approach and Kirschner Wires vs. Extensive Approach and Dedicated Plate-A Retrospective Evaluation at Long-Term Follow-Up. J. Clin. Med., 12.","DOI":"10.3390\/jcm12010020"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00590-023-03760-2","article-title":"The impact of sustentaculum tali fracture on clinical outcome in patients affected by isolated calcaneal fractures","volume":"34","author":"Sani","year":"2024","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1186\/s13018-023-04244-z","article-title":"Finite element analyses of three minimally invasive fixation techniques for treating Sanders type II intra-articular calcaneal fractures","volume":"18","author":"Song","year":"2023","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Mascio, A., Comisi, C., Barlotti, C., Greco, T., Moretti, F., Cinelli, V., De Fazio, A., Mazzella, G.G., Maccauro, G., and Perisano, C. (2025). Management and Treatment Strategies for Distal Tibia and Ankle Infections: Our Clinical Experience. J. Clin. Med., 14.","DOI":"10.3390\/jcm14227967"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41522-025-00754-2","article-title":"Characterizing interactions of Staphylococcus aureus and Escherichia coli in dual-species implant-associated biofilms","volume":"11","author":"Sekar","year":"2025","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00402-026-06199-2","article-title":"The role of the gastrocnemius flap in implant retention strategies for acute periprosthetic joint infection following total knee arthroplasty: A systematic review","volume":"146","author":"Grassa","year":"2026","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1177\/107110070502601112","article-title":"Reliability of the Foot Function Index: A report of the AOFAS Outcomes Committee","volume":"26","author":"Agel","year":"2005","journal-title":"Foot Ankle Int."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/528\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:20:44Z","timestamp":1774272044000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":72,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["life16030528"],"URL":"https:\/\/doi.org\/10.3390\/life16030528","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]}}}