Hence, the disturbance of the LCA c

Hence, the disturbance of the LCA caused by either initial or iatrogenic injury will diminish a largeportion of blood supply to the lateral skin flap andcalcaneus, increasing the likelihood of wound-healingcomplications and nonunion of the fractured calcaneus. As commonly described, the vertical limb of theincision was situated midway between the posterioredge lateral malleolus and lateral edge of the Achillestendon, which would inevitably damage the LCA because the vertical incision was located around thecourse of the lateral calcaneal artery, and the tourniquet was used during the whole procedure [13, 14].To avoid iatrogenic injury to the LCA, Elsaidy et al. introduced a dangerous triangle, which contained thesuperficial course of the LCA as the posterior border,and highlighted that the classically described vertical incision would cross this dangerous triangle and disturbthe LCA [15]. Kwon et al. also found that a more posterior vertical incision decreased in fourfolds the risk ofdamaging the LCA compared to the classical ELA [16].Theoretically, the osteotomy of the calcaneal lateral wall,instead of detaching the lateral soft tissue envelope from the lateral wall of calcaneus, allows tension-free retraction during the operation with the support of lateral wall to avoid injury to the penetrating branchesof the lateral calcaneal artery, eliminate edema between the lateral wall of calcaneus and lateral skinflap, and remove the dead space between the lateralskin flap and implants.