The sinus tarsi approach in displaced intra-articular calcaneal fractures

Introduction Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. Methods Forty-seven consecutive patients with intra-articular calcaneal fractures...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2017-08, Vol.137 (8), p.1055-1065
Main Authors: Park, Jin, Che, Jin Ho
Format: Article
Language:English
Subjects:
Calcaneus - surgery
Foot Injuries - surgery
Fracture Fixation - adverse effects
Fracture Fixation - methods
Fracture Fixation - statistics & numerical data
Humans
Intra-Articular Fractures - surgery
Medicine
Medicine & Public Health
Orthopedics
Range of Motion, Articular
Retrospective Studies
Sinuses
Trauma Surgery
Treatment Outcome
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Summary:Introduction Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. Methods Forty-seven consecutive patients with intra-articular calcaneal fractures treated using the sinus tarsi approach between March 2010 and April 2015 were retrospectively reviewed. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated. Results The mean one-year postoperative VAS and AOFAS scores were 0.54 (range 0–3.0), and 94.0 (range 80–100), respectively. The VAS and AOFAS scores were correlated with the degree of reduction of the posterior facet joint and the amount of Bohler angle restoration. Bony union was achieved in every case. The mean union time was 3.2 months (range 3–4 months). There were no major soft tissue complications. Three cases of minor soft tissue complications healed with no need for subsequent procedures. Painful hardware at the posterior calcaneal tuberosity was the most common complication, which occurred in seven cases. Conclusions The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. Level of evidence IV.
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-017-2714-y