Fixation of displaced intra-articular calcaneus fractures is safe using either sinus tarsi or extensile lateral approach

•139 displaced intra-articular calcaneus fractures treated surgically using sinus tarsi versus extensile lateral approaches were evaluated for acute post-operative complications and post-traumatic sequelae.•Use of the ELA versus STA was not associated with increased risk of superficial or deep infec...

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Bibliographic Details
Published in:Injury 2023-06, Vol.54 (6), p.1824-1830
Main Authors: Joseph, Noah M., Sinkler, Margaret A., Magister, Steven, Bacharach, Abigail, Pang, Aaron, Boes, Kirsten, Vallier, Heather A., Hirschfeld, Adam G., Ochenjele, George
Format: Article
Language:English
Subjects:
Calcaneus fracture
Extensile lateral approach
Functional outcomes
Sinus tarsi approach
Wound complications
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Summary:•139 displaced intra-articular calcaneus fractures treated surgically using sinus tarsi versus extensile lateral approaches were evaluated for acute post-operative complications and post-traumatic sequelae.•Use of the ELA versus STA was not associated with increased risk of superficial or deep infection, posttraumatic arthritis, nonunion, revision surgery, or AOFAS score.•Sanders III and IV fractures had higher rates of complications independent of surgical approach.•Despite increasing saliency of minimally invasive approaches, the ELA remains effective in repair of DIACF and should remain in the arsenal for those facile with it. Management of displaced intra-articular calcaneus fractures continues to challenge surgeons. Use of the extensile lateral surgical approach (ELA) had been standard practice however wound necrosis and infection have become deterrents. The sinus tarsi approach (STA) has gained popularity as a less invasive technique to optimize articular reduction while minimizing soft tissue injury. Our aim was to compare wound complications and infections following calcaneus fractures treated using ELA versus STA. Retrospective review of 139 displaced intra-articular calcaneus fractures (AO/OTA 82C; Sanders II-IV injuries) treated operatively at 2 level-I trauma centers using STA (n = 84) or ELA (n = 55) over a 3-year period with minimum 1-year follow up was performed. Demographic, injury, and treatment-related characteristics were collected. Primary outcomes of interest included wound complications, infection, reoperation, and American Orthopaedic Foot and Ankle Society ankle and hindfoot scores. Univariate comparisons between groups were conducted using Chi-Square, Mann-Whitney, and independent sample t-tests at the p 
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2023.02.036