Calcaneal FracturesNCT07822698
Sustentaculum Tali Screw Fixation Mode and Postoperative Foot-Ankle Function in Calcaneal Fractures
An observational study of Calcaneal Fractures, run by Peking University Third Hospital at 1 site in China.
Trial summary
This is an observational, ambidirectional cohort study. Calcaneal fractures are the most common tarsal bone fractures, and most are intra-articular fractures involving the subtalar joint. Surgery with open reduction and internal fixation is the standard treatment for displaced intra-articular calcaneal fractures. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Calcaneal Fractures
- What is being tested?
- Screw Tip Position Relative to the Sustentaculum Tali
- How many people
- 92 participants
- Where
- 1 siteChina
- Study dates
- 20 Sep 2026to 31 Dec 2028
- How long will I take part?
- 12 Months
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study population consists of adults with intra-articular calcaneal fractures who underwent open reduction and internal fixation at Peking University Third Hospital. Retrospective cases will be identified from January 2015 to August 2026, and prospective cases will be enrolled from September 2026 onward. Participants will be classified into the ST or STF group according to screw tip position on postoperative lateral and axial X-rays. Approximately 92 participants are expected. No treatment is assigned by the study; all participants receive routine clinical care.
Who may be able to join
- Adults aged ≥ 18 years.
- Diagnosis of intra-articular calcaneal fracture.
- Treated with open reduction and internal fixation (ORIF).
- Availability of postoperative lateral and axial X-rays for assessment of screw tip position.
- Complete medical records for retrospective data collection, or willingness to participate in prospective follow-up.
- Written informed consent for prospective participants; informed consent waived for retrospective participants as approved by the ethics committee.
Who cannot join
- Pathological fractures.
- Open calcaneal fractures.
- Previous surgery on the affected calcaneus.
- Severe medical conditions that may affect follow-up or functional assessment.
- Inability to complete follow-up or functional questionnaires.
- Lack of adequate imaging or medical records for group allocation.
- Patients who declined to participate (for prospective cases).
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site
Peking University Third Hospital
Beijing, Beijing Municipality, 100191
Clinical Trial Office, 010 82266699, bysy@bjmu.edu.cn
About this study
Official title: Impact of Sustentaculum Tali Screw Fixation Mode on Radiographic and Functional Outcomes in Patients With Intra-Articular Calcaneal Fractures: An Ambidirectional Cohort Study
This is an observational, ambidirectional cohort study. Calcaneal fractures are the most common tarsal bone fractures, and most are intra-articular fractures involving the subtalar joint. Surgery with open reduction and internal fixation is the standard treatment for displaced intra-articular calcaneal fractures. During surgery, a sustentaculum tali screw is placed from the lateral wall of the calcaneus toward the medial side to support the reduced posterior articular surface. Depending on the screw tip position, fixation is classified as sustentaculum tali fixation (ST; screw fixed directly into the sustentaculum tali) or sustentaculum tali fragment fixation (STF; screw fixed into the larger medial fragment containing the sustentaculum tali). This study compares radiographic reduction quality, foot and ankle function, and complications between these two fixation groups. Approximately 92 participants with intra-articular calcaneal fractures will be enrolled, retrospectively from January 2015 to August 2026 and prospectively from September 2026. The fixation mode is determined on postoperative X-rays. Outcomes, including the Maryland Foot Score, the AOFAS ankle-hindfoot score, Böhler's angle, Gissane's angle, calcaneal height and width, and complications, will be compared between groups over at least 12 months of follow-up. No randomization is performed and no treatment is altered by this study.
Read the detailed description
Background: Calcaneal fractures account for approximately 1% to 2% of all fractures and are the most common tarsal bone fractures, usually caused by high-energy injuries such as falls from height and motor vehicle accidents. Most are intra-articular fractures involving the subtalar joint. Open reduction and internal fixation is the mainstay of treatment for displaced intra-articular calcaneal fractures, aiming to restore the congruity of the subtalar articular surface and the normal morphology of the calcaneus.
The sustentaculum tali is a bony prominence on the medial side of the calcaneus that forms the middle facet of the subtalar joint. Because of its dense bone and strong ligamentous attachments, it is a key anchor point for fracture reduction and internal fixation. During surgery via a lateral approach, a sustentaculum tali screw is inserted from the lateral wall toward the medial side to provide stable support for the reduced posterior articular surface.
Depending on the screw tip position on postoperative imaging, fixation is classified as sustentaculum tali fixation (ST; screw penetrates within the range of the sustentaculum tali) or sustentaculum tali fragment fixation (STF; screw is fixed into the larger medial fragment containing the sustentaculum tali, with the penetration point outside the sustentaculum tali range). Because the sustentaculum tali is small and irregularly shaped, accurate screw placement is technically demanding, with reported accuracy of only 60% to 80% even among experienced surgeons. Recent studies suggest that fixation into the sustentaculum fragment may achieve clinical outcomes similar to precise sustentaculum tali fixation; however, the effect of the different fixation modes on postoperative foot and ankle function remains insufficiently investigated.
Design and methods: This is an ambidirectional cohort study. Approximately 92 participants with intra-articular calcaneal fractures treated by open reduction and internal fixation will be enrolled, including retrospective cases from January 2015 to August 2026 and prospective cases from September 2026. Participants will be naturally allocated to the ST or STF group according to the fixation mode determined on postoperative lateral and axial X-rays; no randomization is performed and no treatment plan is altered by the study.
Data are collected during routine clinical follow-up at 1 week, 6 weeks, 12 weeks, 24 weeks, and 1 year after surgery; no additional examinations or interventions are required. Radiographic parameters (Böhler's angle, Gissane's angle, calcaneal height and width) are measured on pre- and postoperative X-rays, and functional outcomes are assessed with the AOFAS ankle-hindfoot score and the Maryland Foot Score at least 12 months postoperatively.
Statistical analysis: Continuous variables will be compared using the t-test or the Wilcoxon rank-sum test according to their distribution, and categorical variables will be compared using the chi-square test. Two-sided P < 0.05 will be considered statistically significant. Multivariable regression may be used to adjust for potential confounders where appropriate. Analyses will be performed with SPSS 26.0 (IBM, Armonk, NY, USA).
- Conditions
- Calcaneal Fractures
- Being tested
- Screw Tip Position Relative to the Sustentaculum Tali
- Keywords
- Calcaneal Fracture, Sustentaculum Tali Screw
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Screw Tip Position Relative to the Sustentaculum TaliOther
Postoperative screw tip position on lateral and axial X-rays, classified as either ST (within the sustentaculum tali) or STF (in the larger medial fragment, outside the sustentaculum tali range). This is the exposure of interest; the study does not assign this exposure.
| Study group | Role | What they receive |
|---|---|---|
| Sustentaculum Tali (ST) Fixation | Participants with intra-articular calcaneal fractures treated with open reduction and internal fixation. The exposure of interest is screw tip position: the sustentaculum tali screw penetrates within the range of the sustentaculum tali on postoperative lateral and axial X-rays. No treatment was assigned by the study; all participants received routine clinical care. Receives: Other: Screw Tip Position Relative to the Sustentaculum Tali | |
| Sustentaculum Tali Fragment (STF) Fixation | Participants with intra-articular calcaneal fractures treated with open reduction and internal fixation. The exposure of interest is screw tip position: the screw is fixed into the larger medial fragment containing the sustentaculum tali, with the penetration point outside the sustentaculum tali range on postoperative lateral and axial X-rays. No treatment was assigned by the study; all participants received routine clinical care. Receives: Other: Screw Tip Position Relative to the Sustentaculum Tali |
What is being measured
The primary outcome is the main question the study is designed to answer.
Maryland Foot Score
A validated 100-point scoring system for assessing foot function after injury. Domains include pain, gait, distance walked, stability, support, limp, and wearing shoes. Higher scores indicate better function. Score categories: Excellent 90-100; Good 75-89; Fair 50-74; Failure <50.
Measured: At least 12 months postoperatively
AOFAS Ankle-Hindfoot Score
A validated 100-point scoring system for assessing ankle and hindfoot function. Comprises three domains: pain (40 points), function (50 points), and alignment (10 points). Higher scores indicate better function. Score categories: Excellent 90-100; Good 80-89; Fair 65-79; Poor <65.
Measured: At least 12 months postoperatively
Secondary outcomes (5)
Change in Böhler's Angle
Change in Böhler's angle measured on lateral X-rays. Böhler's angle is formed by the intersection of a line from the highest point of the anterior process to the highest point of the posterior facet and a line from the highest point of the posterior facet to the superior margin of the calcaneal tuberosity. Normal range is approximately 20°-40°. A decrease indicates loss of calcaneal height and posterior facet collapse.
Measured: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Gissane's Angle
Change in Gissane's angle measured on lateral X-rays. Gissane's angle is formed at the intersection of the downward and upward slopes of the calcaneal superior surface, located beneath the lateral process of the talus. Normal range is approximately 120°-140°. An increase indicates architectural disruption of the posterior facet.
Measured: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Calcaneal Height
Change in calcaneal height measured on lateral X-rays from preoperative to postoperative and final follow-up. A decrease in calcaneal height indicates collapse of the fractured calcaneus.
Measured: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Calcaneal Width
Change in calcaneal width measured on axial X-rays from preoperative to postoperative and final follow-up. An increase in calcaneal width indicates lateral wall bulging after fracture.
Measured: Preoperative, immediate postoperative, and at least 12 months postoperatively
Postoperative Complications
Number of participants with postoperative complications, including wound infection, screw loosening, sural nerve injury, and other surgery-related adverse events. Complications will be recorded during routine clinical follow-up.
Measured: Up to 12 months postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Sep 2026
- Study start20 Sep 2026 (estimated)
- Primary completion31 Dec 2028 (estimated)
- Study completion31 Dec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Calcaneal FracturesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Other
- Enrolment
- 92 participants (estimated)
- Target duration
- 12 Months
Sponsor and investigators
- Lead sponsor
- Peking University Third Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Zhou Fang, Peking University Third Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07822698
- Sponsor's protocol ID
- PekingUTH ZF SUS Screw
- Status last verified
- Sep 2026
- First submitted
- 12 Sep 2026
- Last updated
- 16 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Sustentaculum Tali Screw Fixation Mode on Radiographic and Functional Outcomes in Patients With Intra-Articular Calcaneal Fractures: An Ambidirectional Cohort Study
- ClinicalTrials.gov ID
- NCT07822698
- Acronym / sponsor ID
- PekingUTH ZF SUS Screw
- Conditions
- Calcaneal Fractures
- Keywords
- Calcaneal Fracture, Sustentaculum Tali Screw
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 92 participants (estimated)
- Lead sponsor
- Peking University Third HospitalUniversity, hospital or other
- Study start
- 20 Sep 2026 (estimated)
- Primary completion
- 31 Dec 2028 (estimated)
- Study completion
- 31 Dec 2028 (estimated)
- First posted
- 16 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is an observational, ambidirectional cohort study. Calcaneal fractures are the most common tarsal bone fractures, and most are intra-articular fractures involving the subtalar joint. Surgery with open reduction and internal fixation is the standard treatment for displaced intra-articular calcaneal fractures. During surgery, a sustentaculum tali screw is placed from the lateral wall of the calcaneus toward the medial side to support the reduced posterior articular surface. Depending on the screw tip position, fixation is classified as sustentaculum tali fixation (ST; screw fixed directly into the sustentaculum tali) or sustentaculum tali fragment fixation (STF; screw fixed into the larger medial fragment containing the sustentaculum tali). This study compares radiographic reduction quality, foot and ankle function, and complications between these two fixation groups. Approximately 92 participants with intra-articular calcaneal fractures will be enrolled, retrospectively from January 2015 to August 2026 and prospectively from September 2026. The fixation mode is determined on postoperative X-rays. Outcomes, including the Maryland Foot Score, the AOFAS ankle-hindfoot score, Böhler's angle, Gissane's angle, calcaneal height and width, and complications, will be compared between groups over at least 12 months of follow-up. No randomization is performed and no treatment is altered by this study.
Detailed description
Background: Calcaneal fractures account for approximately 1% to 2% of all fractures and are the most common tarsal bone fractures, usually caused by high-energy injuries such as falls from height and motor vehicle accidents. Most are intra-articular fractures involving the subtalar joint. Open reduction and internal fixation is the mainstay of treatment for displaced intra-articular calcaneal fractures, aiming to restore the congruity of the subtalar articular surface and the normal morphology of the calcaneus.
The sustentaculum tali is a bony prominence on the medial side of the calcaneus that forms the middle facet of the subtalar joint. Because of its dense bone and strong ligamentous attachments, it is a key anchor point for fracture reduction and internal fixation. During surgery via a lateral approach, a sustentaculum tali screw is inserted from the lateral wall toward the medial side to provide stable support for the reduced posterior articular surface.
Depending on the screw tip position on postoperative imaging, fixation is classified as sustentaculum tali fixation (ST; screw penetrates within the range of the sustentaculum tali) or sustentaculum tali fragment fixation (STF; screw is fixed into the larger medial fragment containing the sustentaculum tali, with the penetration point outside the sustentaculum tali range). Because the sustentaculum tali is small and irregularly shaped, accurate screw placement is technically demanding, with reported accuracy of only 60% to 80% even among experienced surgeons. Recent studies suggest that fixation into the sustentaculum fragment may achieve clinical outcomes similar to precise sustentaculum tali fixation; however, the effect of the different fixation modes on postoperative foot and ankle function remains insufficiently investigated.
Design and methods: This is an ambidirectional cohort study. Approximately 92 participants with intra-articular calcaneal fractures treated by open reduction and internal fixation will be enrolled, including retrospective cases from January 2015 to August 2026 and prospective cases from September 2026. Participants will be naturally allocated to the ST or STF group according to the fixation mode determined on postoperative lateral and axial X-rays; no randomization is performed and no treatment plan is altered by the study.
Data are collected during routine clinical follow-up at 1 week, 6 weeks, 12 weeks, 24 weeks, and 1 year after surgery; no additional examinations or interventions are required. Radiographic parameters (Böhler's angle, Gissane's angle, calcaneal height and width) are measured on pre- and postoperative X-rays, and functional outcomes are assessed with the AOFAS ankle-hindfoot score and the Maryland Foot Score at least 12 months postoperatively.
Statistical analysis: Continuous variables will be compared using the t-test or the Wilcoxon rank-sum test according to their distribution, and categorical variables will be compared using the chi-square test. Two-sided P < 0.05 will be considered statistically significant. Multivariable regression may be used to adjust for potential confounders where appropriate. Analyses will be performed with SPSS 26.0 (IBM, Armonk, NY, USA).
Study design
- Observational model
- Cohort
- Time perspective
- Other
- Target follow-up
- 12 Months
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Sustentaculum Tali (ST) Fixation | – | Other: Screw Tip Position Relative to the Sustentaculum TaliParticipants with intra-articular calcaneal fractures treated with open reduction and internal fixation. The exposure of interest is screw tip position: the sustentaculum tali screw penetrates within the range of the sustentaculum tali on postoperative lateral and axial X-rays. No treatment was assigned by the study; all participants received routine clinical care. |
| Sustentaculum Tali Fragment (STF) Fixation | – | Other: Screw Tip Position Relative to the Sustentaculum TaliParticipants with intra-articular calcaneal fractures treated with open reduction and internal fixation. The exposure of interest is screw tip position: the screw is fixed into the larger medial fragment containing the sustentaculum tali, with the penetration point outside the sustentaculum tali range on postoperative lateral and axial X-rays. No treatment was assigned by the study; all participants received routine clinical care. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study population consists of adults with intra-articular calcaneal fractures who underwent open reduction and internal fixation at Peking University Third Hospital. Retrospective cases will be identified from January 2015 to August 2026, and prospective cases will be enrolled from September 2026 onward. Participants will be classified into the ST or STF group according to screw tip position on postoperative lateral and axial X-rays. Approximately 92 participants are expected. No treatment is assigned by the study; all participants receive routine clinical care.
Key inclusion criteria (6 listed)
- Adults aged ≥ 18 years.
- Diagnosis of intra-articular calcaneal fracture.
- Treated with open reduction and internal fixation (ORIF).
- Availability of postoperative lateral and axial X-rays for assessment of screw tip position.
- Complete medical records for retrospective data collection, or willingness to participate in prospective follow-up.
Key exclusion criteria (7 listed)
- Pathological fractures.
- Open calcaneal fractures.
- Previous surgery on the affected calcaneus.
- Severe medical conditions that may affect follow-up or functional assessment.
- Inability to complete follow-up or functional questionnaires.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Screw Tip Position Relative to the Sustentaculum TaliPostoperative screw tip position on lateral and axial X-rays, classified as either ST (within the sustentaculum tali) or STF (in the larger medial fragment, outside the sustentaculum tali range). This is the exposure of interest; the study does not assign this exposure. | Other | Sustentaculum Tali (ST) Fixation, Sustentaculum Tali Fragment (STF) Fixation |
Primary outcome
Maryland Foot Score
Time frame: At least 12 months postoperatively
A validated 100-point scoring system for assessing foot function after injury. Domains include pain, gait, distance walked, stability, support, limp, and wearing shoes. Higher scores indicate better function. Score categories: Excellent 90-100; Good 75-89; Fair 50-74; Failure <50.
AOFAS Ankle-Hindfoot Score
Time frame: At least 12 months postoperatively
A validated 100-point scoring system for assessing ankle and hindfoot function. Comprises three domains: pain (40 points), function (50 points), and alignment (10 points). Higher scores indicate better function. Score categories: Excellent 90-100; Good 80-89; Fair 65-79; Poor <65.
5 secondary outcomes
Change in Böhler's Angle
Time frame: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Gissane's Angle
Time frame: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Calcaneal Height
Time frame: Preoperative, immediate postoperative, and at least 12 months postoperatively
Change in Calcaneal Width
Time frame: Preoperative, immediate postoperative, and at least 12 months postoperatively
Postoperative Complications
Time frame: Up to 12 months postoperatively
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2026.
- Individual participant dataSharing planned: No
Related trials for Calcaneal Fractures
Recruiting
Primary Subtalar Arthrodesis for Calcaneal Fractures
Calcaneus Fracture
Not yet recruitingObservational study
Calcaneal Angles And Postoperative Body Balance Following Internal Fixation
Body Balnace and Calcaneal Fractures
Not yet recruitingPhase 1
Enhancing Wound Perfusion in High-Risk Lower Extremity Orthopaedic Surgery: A Study on Nitropaste Using Intraoperative SPY Imaging.
Achilles Tendon Repairs/Reconstructions, Pilon Fracture of Tibia
Recruiting
Performance and Safety Evaluation of Inion CompressOn Screw in Foot and Ankle Surgeries. PMCF Investigation
Medial Malleolus Fracture, Lisfranc Injury
Not yet recruiting
Comparative Study Between Internal Fixtion And Primary Subtalar Arthrodesis In Comminuted Intra-Articular Calcaneal Fracture
Calcaneus Fractures
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Calcaneal Fractures, run by Peking University Third Hospital at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Clinical Trial Office (010-82266699, bysy@bjmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Maryland Foot Score (time frame: At least 12 months postoperatively). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2026.