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We hypothesized that the sustentacular fragment in displaced intra-articular calcaneal fractures does not maintain its relationship to the talus. Operative treatment typically occurs through a lateral approach, with the remaining calcaneus being reconstructed back to the sustentaculum. 距下关节后侧入路关节镜辅助下闭合复位经皮空心螺钉固定可有效治疗 Essex-Lopresti 舌型及 Sanders ⅡA、ⅡB、ⅢAB 型跟骨骨折，创伤小、并发症少、功能恢复优良，发挥了微创手术的优势。.Ĭalcaneal fracture arthroscopy closed reduction internal fixation minimally invasive technique.The sustentacular fragment in displaced intra-articular calcaneal fractures has historically been portrayed as a "constant fragment," bound to the talus by the interosseous and deltoid ligament complex. It has the advantages of little trauma, less complication, and good function recovery to use arthroscopically-assited closed reduction and percutaneous screw fixation by posterior approach to subtalar joint for calcaneal fractures of Essex-Lopresti tongue type, Sanders IIA, Sanders IIB, and Sanders IIIAB. The AOFAS score results were excellent in 11 cases, good in 3 cases, and fair in 2 cases, and the excellent and good rate was 87.5%. The Böhler angle, Gissane angle, and calcaneal width were significantly improved at 3 days and 6 months after operation when compared with preoperative ones ( P0.05). Achilles tendon irritation occurred in 2 cases, and disappeared after removal of internal fixation traumatic arthritis occurred in 2 cases, and was relieved after removal of internal fixation. The X-ray films showed that fracture line disappeared at 6 months after operation the patients had no tenderness or percussion pain, no breakage or loosening of internal fixation, no varus calcaneus tuberosity, no subtalar joint fusion, and no compression symptoms of peroneal tendons. The patients were followed up 12-15 months (mean, 13.63 months). Primary healing of incision was obtained in all cases, and no complications of infection, necrosis, and osseous fascia compartment syndrome occurred.

American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate the ankle function at 12 months after operation.

The Böhler angle, Gissane angle, and width of calcaneus were measured before and after operation. The interval of injury and operation was 4-8 days (mean, 5.94 days). Of 16 cases, 4 were classified as Essex-Lopresti tongue type, 5 as Sanders IIA, 4 as Sanders IIB, and 3 as Sanders IIIAB. The injury causes included falling from height in 10 cases and traffic accident in 6 cases. There were 13 males and 3 females with an average age of 37.8 years (range, 18-65 years). Sixteen patients with unilateral calcaneal fracture were treated with arthroscopically-assisted closed reduction and percutaneous screw fixation by posterior approach to subtalar joint between June 2012 and June 2015.

To evaluate the results of arthroscopically-assisted closed reduction and percutaneous screw fixation by posterior approach to subtalar joint for calcaneal fractures of Essex-Lopresti tongue type, Sanders IIA, IIB, and IIIAB.