Application effect of closed reduction and cannulated screw fixation via a 3D-printed guide in elderly patients with osteoporotic calcaneal fracture
XIE Zikang
SHI Mingyu
JIANG Tao
LI He
WANG Yu
Abstract：Objective To investigate the effect of closed reduction and cannulated screw fixation via a 3D-printed guide in the treatment of elderly patients with osteoporotic calcaneal fracture and its effect on postoperative early pain and complications.Methods A total of 98 elderly patients with osteoporotic calcaneal fractures admitted from May 2023 to April 2024 were selected and divided into the observation group and the control group by random number table method,with 49 patients in each group.The control group was treated with open reduction and internal fixation with lateral L-shaped incision,and the observation group was treated with closed reduction and cannulated screw fixation via a 3D-printed guide.The operation-related indexes,imaging indexes before and after operation,pain mediators[prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT),substance P]levels before operation,and at 1 d,3 d and 7 d after operation,incidence of soft tissue complications and Marland score of foot function at 1 year after operation were compared between the two groups.Results The number of X-ray fluoroscopy and blood loss in the observation group were less than those in the control group,and the duration of operation and length of postoperative hospital stay were shorter than those in the control group(P＜0.05).The calcaneal height and Böhler angle of the two groups after operation were higher than those before operation,while the calcaneal width and Gissane angle were lower than those before operation(P＜0.05).The levels of serum PGE2,5-HT and substance P in the observation group were lower than those in the control group at 1,3 and 7 d after operation(P＜0.05).The incidence of soft tissue complications in the observation group[0(0/49)]was lower than that in the control group[18.37％(9/49)](P＜0.05).At 3 months after operation,the Marland score of the observation group was higher than that of the control group,and the Marland classification was better than that of the control group(P＜0.05).There was no significant difference in Marland score and Marland classification between the two groups at 12 months after operation(P＞0.05).Conclusion The short-term efficacy of closed reduction and cannulated screw fixation via a 3D-printed guide is comparable to that of open reduction and internal fixation,but it has lower requirements for soft tissue,less postoperative pain,fewer soft tissue complications,and faster postoperative recovery.
Keywords：osteoporosiscalcaneal fracture3D-printed guideclosed reductioncannulated screwpaincomplicationsold age
Publication Date：2026-02-28
Online Publishing Date：2026-03-17(First online date of this platform, not the publication date of the document)
Pages：7( 38-44 )