Minimally Invasive Reverse Traction Using Kirschner Wire Retractor for Sanders II and III Calcaneal Fractures: Clinical Outcomes and Advantages

This retrospective study evaluated the clinical efficacy of a minimally invasive technique involving reverse traction reduction using a Kirschner wire distractor combined with cannulated screw fixation for treating Sanders type II and III calcaneal fractures. A total of 66 patients were analyzed, with 33 treated using the novel minimally invasive method and 33 treated with conventional open reduction and internal fixation using plates. Compared to the control group, the minimally invasive group showed significantly reduced intraoperative blood loss, operative time, hospital stay, and treatment costs, though it required more intraoperative fluoroscopy. Fracture healing time was comparable between groups. At 3 months postoperatively, radiographic outcomes including Böhler and Gissane angles improved significantly in both groups without significant differences between them. The minimally invasive group experienced lower postoperative pain scores and fewer complications. At final follow-up, this group also demonstrated higher AOFAS ankle–hindfoot scores and a greater rate of excellent and good outcomes. These findings suggest that the described minimally invasive approach is a safe and effective alternative to traditional open surgery, offering advantages in surgical trauma, recovery time, and complication rates, although the increased need for fluoroscopy warrants consideration.