{
  "abstract": "This case report describesthe surgical technique and clinical outcome of biologic fixation using a semiring external fixator combined with limited-incision Kirschner wire (K-wire) stabilization in the treatment of a Sangeorzan type III navicular fracture-a complex injury typically associated with comminution, medial column shortening, and challenges in maintaining reduction without extensive soft-tissue dissection. A 33-year-old woman presented with a comminuted right navicular body fracture (Sangeorzan type III) following a traffic accident. A minimally invasive approach guided by biologic fixation principles was employed. A semiring external fixator was applied to achieve ligamentotaxis-assisted indirect reduction through distraction across the surrounding talonavicular and naviculocuneiform capsuloligamentous structures with mild forefoot abduction, restoring navicular height and midfoot alignment. Through a limited dorsal incision over the dorsal aspect of the navicular, two 2.0-mm K-wires were inserted under limited direct visualization and fluoroscopic guidance in a point-to-point manner to stabilize key fracture fragments. The external fixator was adjusted weekly, removed at 4 weeks, and the fracture-fixation K-wires were removed at 6 weeks, followed by a staged weight-bearing rehabilitation protocol. At 12-month follow-up, radiographic evaluation demonstrated solid bony union. The patient was able to bear full weight without pain or tenderness. The American Orthopaedic Foot & Ankle Society (AOFAS) midfoot score was 90, indicating excellent functional recovery. The combination of semiring external fixation and limited-incision K-wire fixation enabled effective, blood-supply-sparing reduction and elastic stabilization in a complex Sangeorzan type III navicular fracture. This biologic fixation strategy may offer a valuable alternative to conventional open reduction and internal fixation (ORIF) in selected comminuted navicular fractures.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Trauma, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Haixiang Sun",
      "orcid": "0009-0007-0123-6102"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhenglin Niu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yue Lian"
    },
    {
      "affs": [
        0
      ],
      "name": "Changlong Shi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e3v1p6yxq1e82.bib",
  "cited_by": 0,
  "doi": "10.21037/aoj-2026-0028",
  "fulltext_url": "https://europepmc.org/articles/PMC13743886",
  "id": "e3v1p6yxq1e82",
  "issns": [
    "2415-6809"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999479",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Foot and Ankle Surgery"
    ]
  ],
  "openalex": "W7222601962",
  "pdf_url": "https://europepmc.org/articles/PMC13743886?pdf=render",
  "pmcid": "PMC13743886",
  "pmid": "42999479",
  "published": "2026-07-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/e3v1p6yxq1e82.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:42Z",
      "native_id": "MED:42999479",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999479"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Foot and Ankle Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Minimally invasive biological fixation of comminuted navicular fracture using semi-circular external fixator combined with Kirschner wire: a case report.",
  "title_text": "Minimally invasive biological fixation of comminuted navicular fracture using semi-circular external fixator combined with Kirschner wire: a case report.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:42Z",
  "url": "https://research.draconitic.com/paper/e3v1p6yxq1e82",
  "venue": "Annals of joint",
  "versions": []
}