Treatment of Sanders Type 2A Calcaneal Fractures
Sanders type 2A calcaneal fractures require surgical fixation with open reduction and internal fixation (ORIF) as the primary treatment approach, guided by 3D CT mapping to optimize fragment reduction and hardware placement. 1
Diagnostic Evaluation and Surgical Planning
Sanders type 2A fractures represent joint depression calcaneal fractures with a specific fracture pattern that can be precisely characterized using 3D CT reconstruction. 1
- 3D CT imaging with fracture mapping is essential for accurate classification and surgical planning, as it allows visualization of the exact fracture line distribution and fragment displacement 1
- In Sanders type 2A fractures specifically, the most common involvement patterns in the anterior process of the calcaneus (APC) and middle talar joint are type AC and type AD 1
- The 3D reconstruction allows surgeons to create individualized surgical approaches and optimize internal fixation design based on the specific fracture geometry 1
Surgical Treatment Approach
Open reduction and internal fixation (ORIF) is the standard surgical treatment for Sanders type 2A fractures, as these are intra-articular fractures requiring anatomic reduction of the posterior facet. 1
Key Surgical Principles:
- Anatomic reduction of articular fragments is critical, with the 3D fracture map guiding the reduction sequence 1
- Internal fixation design should be customized based on the fracture line distribution identified on the preoperative 3D CT mapping 1
- The segment and split functions in surgical planning software allow precise preoperative planning of fragment reduction 1
Common Pitfalls and Caveats
- Failure to obtain 3D CT reconstruction can lead to underappreciation of fracture complexity and suboptimal surgical planning 1
- Sanders type 2A fractures can be confused with other Sanders type 2 subtypes (2B and 2C) without proper 3D imaging, leading to inappropriate surgical approaches 1
- The characteristic fracture map for type 2A differs from 2B and 2C patterns, making accurate classification essential for optimal outcomes 1