Gait characteristics and functional outcomes during early follow-up are comparable in patients with calcaneal fractures treated by either the sinus tarsi or the extended lateral approach

2019 ◽  
Vol 70 ◽  
pp. 190-195 ◽  
Author(s):  
Andreas Brand ◽  
Isabella Klöpfer-Krämer ◽  
Moritz Böttger ◽  
Inga Kröger ◽  
Leander Gaul ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Lateral Approach ◽  
Calcaneal Fractures ◽  
Gait Characteristics ◽  
Sinus Tarsi ◽  
Extended Lateral Approach

scholarly journals Use of the Extended Sinus Tarsi Approach for Treatment of Displaced Intra-articular Calcaneal Fractures Compared with the Extended Lateral Approach

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0027
Author(s):  
Chan Kang ◽  
Dong Yeol Kim ◽  
Jae-Hwang Song ◽  
Jeong-kil Lee ◽  
Seokhwan Song ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Lateral Approach ◽  
Wound Complications ◽  
Pain Patient ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Patient Reported ◽  
Extended Lateral Approach

Category: Trauma Introduction/Purpose: We compared the radiographic results and clinical outcomes of patients with displaced, intra-articular calcaneal fractures treated via the extended sinus tarsi approach (ESTA) and the extended lateral approach (ELA). Methods: We retrospectively studied the utility of the ELA (46 patients, 52 feet) and the ESTA (56 patients, 64 feet) in patients operated upon between January 2009 and September 2014. We evaluated pre- and post-operative X-rays and computed tomography (CT) data. Pain, patient-reported functional outcomes, patient satisfaction, and postoperative complications, were investigated at the three year follow-up. Results: Neither the postoperative nor three year follow-up Böhler angles, nor the calcaneal width, differed significantly between the two groups (both p > 0.05). The maximum step-off of the posterior facet on the three month CT follow-up of the ESTA was significantly less than that of the ELA (p < 0.05). We found no significant between-group differences in terms of postoperative translation (p = 0.232) or angulation of the sustentacular fragment (p = 0.132), three year follow-up mean visual analog scale pain score at rest (p = 0.641) or during weight-bearing (p = 0.525), Foot Function Index (FFI) (p = 0.712), and self-reported satisfaction (p = 0.823). The ELA experienced significantly more wound complications (p = 0.039) and nonunions (p = 0.014) than the ESTA. Conclusion: Compared with the ELA, the ESTA afforded comparable radiological results and clinical outcomes, associated with a reduced operative time and fewer wound complications and nonunions. We suggest that the ESTA is an efficient surgical option when treating displaced, intra-articular calcaneal fractures.

Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach

2018 ◽  
Vol 40 (2) ◽  
pp. 167-177 ◽  
Author(s):  
Jae Hwang Song ◽  
Chan Kang ◽  
Deuk Soo Hwang ◽  
Dong Hun Kang ◽  
June Woo Park
Keyword(s):  
Clinical Outcomes ◽  
Lateral Approach ◽  
Wound Complications ◽  
Pain Patient ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Patient Reported ◽  
Extended Lateral Approach

Background: We compared the radiographic results and clinical outcomes of patients operated on via the extended sinus tarsi approach (ESTA) and the extended lateral approach (ELA) for treatment of displaced intraarticular calcaneal fractures. Methods: We retrospectively studied the utility of the ELA (46 patients, 52 feet) and the ESTA (56 patients, 64 feet) in patients operated on between January 2009 and March 2015. We evaluated pre- and postoperative x-rays and computed tomography (CT) data. Pain, patient-reported functional outcomes, satisfaction, and postoperative complications were investigated at the 3-year follow-up. Results: Neither the postoperative nor 3-year follow-up Böhler angles, nor the calcaneal width, differed significantly between the 2 groups (both P > .05). However, the maximum step-off of the posterior facet on the 3-month CT follow-up of the ESTA group was significantly less than that of the ELA group ( P < .05). We found no significant between-group differences in terms of postoperative translation ( P = .232) or angulation ( P = .132) of the sustentacular fragment on the 3-month CT follow-up. At the 3-year follow-up, we found no significant between-group difference in the mean visual analog scale pain score at rest ( P = .641) or during weightbearing ( P = .525). We found no significant between-group difference in the Foot Function Index (FFI) ( P = .712) or self-reported satisfaction ( P = .823). The ELA group experienced significantly more wound complications ( P = .041) and nonunions ( P = .041) than the ESTA group. Four instances of superficial peroneal nerve injury were reported in the ESTA group ( P = .127). Conclusion: Compared with the ELA, the ESTA afforded comparable, favorable radiological results and clinical outcomes, associated with fewer wound complications and nonunions. We suggest that the ESTA is an effective operative option when treating displaced, intraarticular calcaneal fractures. Level of Evidence: Level III, comparative study.

scholarly journals The Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Yunfeng Yang ◽  
Haichao Zhou ◽  
Yun Zhang
Keyword(s):  
Open Reduction ◽  
Lateral Approach ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Extensile Lateral Approach ◽  
Hind Foot ◽  
Approach Group ◽  
Varus Angle

Category: Hindfoot Introduction/Purpose: To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via sinus tarsi approach using medial distraction technique for intra-articular calcaneal fractures. Methods: We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015, including 32 cases of Sanders type? and 33 of Sanders type?. There were 49 men and 16 women. The mean age was 43.7 years old. They were divided into two groups: sinus tarsi approach group and extensile lateral approach group. No significant difference was found in gender, age, injury pattern, fracture classification between two groups (P>0.05). The Böhler angle, Gissane angle and calcaneal varus angle were measured before surgery, 1 week after surgery and at each follow-up visit respectively. The postoperative function was evaluated by the ankle and hind-foot score of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS). Results: All of the fractures were healed at about 10 weeks postoperatively. Böhler angle, Gissane angle and calcaneal varus angle were restored obviously, while there was no significant statistically difference between the two groups. Only the corrected value of calcaneal varus angle is statistically significant.At the last follow-up, the average AOFAS ankle and hind-foot score of minimal group was 88.4±6.6, and the VAS score was 1.9±0.7, while of extensile lateral approach group was 83.2±5.6 and 2.3±1.0 respectively. Conclusion: Limited open reduction via sinus tarsi approach for intra-articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful to correct the calcaneus varus deformity.

scholarly journals A Modified Sinus Tarsi Approach for Treatment of Displaced Intra-articular Calcaneal Fractures Sanders type Ⅱ or Ⅲ Compared to Extended Lateral Approach

2020 ◽  
Author(s):  
Yao Hu ◽  
Junfeng Zhan ◽  
Congpeng Meng ◽  
Zhida Ma ◽  
Nan Zhu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Lateral Approach ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Aofas Score ◽  
Vas Score ◽  
Sinus Tarsi Approach ◽  
Extended Lateral Approach ◽  
Good Rating

Abstract Background: We have designed a modified sinus tarsi approach (MSTA) to treat sanders type Ⅱ or Ⅲ intra-articular calcaneal fractures, providing sufficient surgical field exposure and operation space, and significantly reducing the rate of wound complications. We compared the radiologic results, clinical outcomes, and complications of patients operated on via the MSTA and the extended lateral approach (ELA) for treatment of displaced intraarticular calcaneal fractures Sanders type Ⅱ or Ⅲ.Methods: We retrospectively studied the utility of the ELA (32 patients, 34 feet) and the MSTA (33 patients, 36 feet) operated on from January 2013 to January 2018. The average follow-up time of the two groups was 58 months. We assessed the preoperative and final x-rays, clinical outcomes and complications at the last follow-up. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analog scale (VAS).Results: In both groups, the average final width, height, Bohler angle were significantly restored compared with the preoperative width, height, and Bohler. The last follow-up calcaneal length, width, height, Bohler angle, Gissane angle did not differ significantly between the 2 groups. In terms of the clinical outcomes, the average AOFAS score of the ELA group checked to 82.1 points, yielding a 77.8% excellent or good rating, and the average VAS score was 1.76 points. In contrast, the average AOFAS score of the MSTA group checked to 81.0 points, yielding a 79.4% excellent or good rating, and the average VAS score was 1.68 points. There was no significant difference in AOFAS score and VAS score between the 2 groups. The wound-healing complication rate was 2.9% in MSTA group and 22.2% in ELA group (p = .040). 4 cases of sural nerve injury occurred in ELA group, and 2 in MSTA group. 1 cases of peroneal tendon complication only occurred in ELA group.Conclusion: Compared with ELA, MSTA provides similar and favorable radiological and clinical results, and is associated with fewer wound complications. We believe the MSTA is more appropriate in the treatment of Sanders II and III calcaneal intra-articular fractures.

A systematic review and meta-analysis of the sinus tarsi and extended lateral approach in the operative treatment of displaced intra-articular calcaneal fractures

2019 ◽  
Vol 25 (5) ◽  
pp. 580-588 ◽  
Author(s):  
Tomasz L. Nosewicz ◽  
Siem A. Dingemans ◽  
Manouk Backes ◽  
Jan S.K. Luitse ◽  
J. Carel Goslings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Meta Analysis ◽  
Lateral Approach ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Extended Lateral Approach
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