Evaluation and quantification of geographical differences in wound complication rates following the extended lateral approach in displaced intra-articular calcaneal fractures – A systematic review of the literature

Injury ◽  
2017 ◽  
Vol 48 (10) ◽  
pp. 2329-2335 ◽  
Author(s):  
M. Backes ◽  
K.E. Spierings ◽  
S.A. Dingemans ◽  
J.C. Goslings ◽  
R.E. Buckley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Complication ◽  
Lateral Approach ◽  
Complication Rates ◽  
Review Of The Literature ◽  
Calcaneal Fractures ◽  
Geographical Differences ◽  
Extended Lateral Approach

scholarly journals Sinus Tarsi Approach for Open Treatment and Internal Fixation of Displaced Intra-articular Calcaneal Fractures in High-Risk Patients: The New Gold Standard?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0015
Author(s):  
James P. Davies ◽  
W. Bret Smith ◽  
Steven Steinlauf ◽  
Mary Millikin
Keyword(s):  
High Risk ◽  
Gold Standard ◽  
Wound Complication ◽  
Lateral Approach ◽  
Wound Complications ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Extensile Lateral Approach

Category: Ankle, Diabetes, Hindfoot, Trauma Introduction/Purpose: Intra-articular calcaneal fractures offer unique challenges. Wound problems and infection are significant complications in the surgical treatment of calcaneal fractures which in turn can be debilitating to patients and outcomes. The literature suggests varying wound complication rates but 21% up to 33% using the traditional extensile lateral approach in some studies. The extensile lateral approach has historically been accepted as the gold standard for fixation and treatment of these fractures. Recently there has been resurgent interest in alternative approaches to the fixation of intra-articular calcaneal fractures. Of interest is the potential of the sinus tarsi approach to decrease wound complications while having comparable reduction quality to the higher wound risk extensile lateral approach. Methods: A multi-center retrospective chart review study was implemented. The study objective was to review wound complication of the sinus tarsi approach compared with outcomes from the traditional extensile approach for fixation of displaced intra-articular calcaneal fractures. Specifically; examining a population of patients considered at high risk for wound issues, comparing radiographic and clinical outcomes. Results: In the high-risk group, only one primary complications resulted, including one patient with a history of an open fracture. All fractures healed with adequate maintenance of alignment. Chi- squared analysis resulted in a statistically significant difference in complication rates between sinus tarsi and the traditional extensile lateral approach at the 95% confidence level. Conclusion: In both high-risk and lower-risk cohorts of patients, a low rate of infection and wound problems was encountered. A limited approach through a sinus tarsi incision provides a viable option to treat displaced intra-articular calcaneus fracture patients with risk factors for wound issues. The patients all healed both their soft tissue wounds and fractures. Functional return was consistent with other study populations. Our study adds another cohort of patient data demonstrating the advantage of the sinus tarsi approach when compared to the extensile lateral in terms of decreased wound complications while maintaining quality of reductions and clinical outcomes.

scholarly journals Comparison of sinus tarsi approach and extensile lateral approach for calcaneal fractures: A systematic review of overlapping meta-analyses

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902091528 ◽  
Author(s):  
Tao Yu ◽  
Yuan Xiong ◽  
Alex Kang ◽  
Haichao Zhou ◽  
Wenbao He ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lateral Approach ◽  
Cochrane Library ◽  
Wound Complications ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Extensile Lateral Approach ◽  
Meta Analyses

Purpose: Accumulated literature has reported the comparative efficacy of the sinus tarsi approach (STA) and the extensile lateral approach (ELA) for the treatment of calcaneal fractures (CFs). However, the best alternative treatment for CF is still inconsistent. Herein, the present systematic review of overlapping meta-analyses aims to achieve an evident conclusion by performing a comprehensive reanalysis of previous meta-analyses regarding the comparison of the STA and the ELA. Methods: We searched several databases, including Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov , OVID, and CNKI for the meta-analyses comparing the STA and the ELA for the treatment of CF. All related meta-analyses of randomized controlled trials and cohort studies were included. Two researchers independently assessed the quality of the articles and extracted the data. The Jadad decision algorithm was used to evaluate the evidence of the articles. Results: Ultimately, five meta-analyses were included in the present study. The Assessment of Multiple Systematic Reviews scores of these articles ranged from 5 to 9 with a median of 7. The analysis of best quality, Bai 2018, was selected based on the Jadad algorithm. In this article, the significant differences were found in wound complications and operating time, recovery of Böhler’s angle, the American Orthopaedic Foot and Ankle Society scores, and the visual analog scale. Conclusion: The clinical relevance of the present study is that both the STA and the ELA are effective in alleviating pain and improving functionality in the treatment of CF. However, due to a shorter operation duration and lower complication rates, the STA was indicated to be a superior alternative for CF treatment.

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

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.

scholarly journals Functional outcome of operatively treated displaced intra-articular calcaneal fractures using two parallel contoured reconstruction plates

1970 ◽  
Vol 8 (1) ◽  
pp. 12-17
Author(s):  
S Lakhey ◽  
RR Manandhar ◽  
RL Pradhan ◽  
BK Pandey ◽  
S Sharma ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Scoring System ◽  
Surgical Techniques ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Articular Fractures ◽  
Intraarticular Fractures

Introduction: The treatment of displaced intra-articular calcaneal fracture is controversial. Conventionally, they were treated non-operatively. However, some surgeons are now operatively treating these fractures because of continuing dissatisfaction with the outcome of conservative treatment of these fractures and improvements that have occurred in surgical techniques and complication rates. Objective: The aim of this study was to determine the functional outcome of operatively treated displaced intra-articular calcaneal fractures using two parallel contoured reconstruction plates. Materials and methods: 12 patients with 14 displaced intra-articular calcaneal fractures involving the subtalar joint were included in the study conducted between July 2005 and December 2008. The fracture site was exposed using extended lateral approach. Internal fixation was done by two nearly parallel 3.5mm reconstruction plates and screws contoured to form a gentle curve in all cases with the first plate fixed just below the articular surface. At the end of follow up, the patients' foot function was assessed by Calcaneal Fracture Scoring System of Kerr et al. Patients were also enquired about their satisfaction with their treatment outcome. Results: The patients were followed up for duration of 12 to 24 months (mean 15.64 months). The outcome score as measured by Calcaneal Fracture Scoring System ranged from 48 to 94 (mean 83.64). 11 of 12 patients (91.6 %) were satisfied with the treatment. Conclusion: Displaced intra-articular fractures treated by open reduction and internal fixation, using two nearly parallel, contoured reconstruction plates through an extensile lateral approach and following the principles of treatment of intraarticular fractures, have good functional results with high patient satisfaction rate. Key words: displaced intra-articular calcaneal fractures; operative treatment. DOI: 10.3126/kumj.v8i1.3215 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 12-17

scholarly journals Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

2013 ◽  
Vol 38 (4) ◽  
pp. 767-773 ◽  
Author(s):  
Manouk Backes ◽  
Tim Schepers ◽  
M. Suzan H. Beerekamp ◽  
Jan S. K. Luitse ◽  
J. Carel Goslings ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Lateral Approach ◽  
Wound Infections ◽  
Calcaneal Fractures ◽  
Extended Lateral Approach
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