Objective To compare the effectiveness of Holosight robot-assisted percutaneous reduction and internal fixation versus reduction and internal fixation via sinus tarsi approach in treatment of calcaneal fractures. Methods A retrospective analysis was conducted on 46 cases (46 feet) of closed intra-articular calcaneal fractures classified as Sanders type Ⅱ or Ⅲ, admitted between June 2022 and June 2025. Among them, 20 patients were treated with Holosight robot-assisted percutaneous reduction and internal fixation (RA group), and 26 with open reduction and internal fixation via sinus tarsi approach (control group). There was no significant difference between groups (P>0.05) in age, gender, affected side, fracture classification, the interval between fracture and operation, and preoperative visual analogue scale (VAS) score for pain, American Orthopedic Foot and Ankle Association (AOFAS) score, calcaneal morphological parameters (length, width, height, B?hler angle, Gissane angle). The two groups were compared in terms of operation time, intraoperative blood loss, fluoroscopy frequency, screw (guide wire) adjustment times, initial screw (guide wire) implantation success rate, incidence of complications, and the differences in calcaneal morphological parameters, pain and functional outcomes (VAS and AOFAS scores) between pre- and post-operation. Results Compared with the control group, the RA group had significantly less intraoperative blood loss, fewer fluoroscopy frequency, fewer screw (guide wire) adjustments, higher initial screw (guide wire) implantation success rate, and shorter operation time and hospital stay (P<0.05). No postoperative complication occurred in RA group, whereas 1 case of superficial incision infection was observed in control group; however, there was no significant difference in the incidence of complications between groups (P>0.05). All patients were followed up 6-7 months (mean, 6.5 months). X-ray film at last follow-up showed that all fractures healed. At 6 months after operation, the calcaneal morphological parameters and pain and functional indicators all significantly improved when compared with the preoperative values in the two groups (P<0.05). The changes in VAS score and AOFAS score differed significantly between the two groups (P<0.05), whereas no significant difference was found in the changes of the other indicators (P>0.05). Conclusion Compared with the operation via sinus tarsi approach, Holosight robot-assisted percutaneous reduction and internal fixation for calcaneal fractures demonstrates superior safety and effectiveness, as evidenced by shortened operation and hospital stay, reduced intraoperative blood loss and the fluoroscopy frequency, improved screw placement accuracy, enhanced postoperative functional recovery.
Citation：
WU Zhenhua, ZHOU Wei, ZHANG Hao, MA Min, TAN Kaifan, XIE Meiming, LIAO Dongfa. Study on Holosight robot-assisted fixation versus fixation via sinus tarsi approach in treatment of calcaneal fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(5): 764-771. doi: 10.7507/1002-1892.202512106
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