The mean AOFAS score at the last fo

The mean AOFAS score at the last follow-up was84.37 ± 9.98 (range, 65–95), with 9, 6, and 4 feet havingexcellent, good, and fair rates, respectively (Table 2). Theexcellent and good rates account for 78.95% of all cases.The 4 feet with fair AOFAS score were those of patientswith Sander’s type IV fracture. No nonunion, delayedunion, or malunion was observed after a mean follow-upperiod of 34.69 ± 5.22 (range, 28–48) months. Allreturned to pre-injury work, and none required secondary surgery for implant removal.ComplicationsOnly one superficial infection occurred 6 days post-surgery,and it was resolved by cutting several intense sutures immediately, extending the administration of 1.5 g cefuroximesodium twice a day for 5 days and changing dressings morefrequently. One screw breakage was found in a patient atthe last follow-up, which may be due to walking withweight-bearing earlier than we proposed. No gap > 3 mmor step-off > 2 mm of the subtalar joint and no paresthesiawere found in all limbs. No soft tissue reaction was foundin all feet at the final follow-up.DiscussionOur findings revealed that our novel technique had alow rate of wound-healing complications. To avoiddamage to the LCA, a vertical incision was done atthe posterior one-third distance between the posteriorborder of the lateral malleolus and the lateral borderof the Achilles tendon. Moreover, the full-thicknesslateral flap, containing the lateral wall of calcaneus instead of peeling the lateral skin flap from the lateralwall, circumvented the disturbance of the sural nerveand the angiosome to the lateral skin flap. The LCAwith a 6-mm diameter consists of an intricate vesselnet surrounding the lateral hind foot and lateral malleolus and provides approximately 14% of blood supply to the skin flap in this area [11]. Several branchesof the LCA penetrate the lateral wall of the calcaneus,accounting for approximately 45% of its blood supply[12].