Comparison between Percutaneous Screw Fixation and Plate Fixation
            
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            Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Abstract Background Sinus tarsi approach and mini-calc plate have been used for intra-articular calcaneal fractures. However, the sinus tarsi approach has limited exposure to the lateral wall, which makes it challenging to obtain an excellent anatomic reduction of the calcaneal body. What is more! To restore the width of the calcaneal body entirely and prevent the heel varus simultaneously with mini-calc plate was tough as well. Aimed to solve the aforementioned problems, our study focused on using the Steinmann pin retractor for reduction and the circle plate for fixation via the sinus tarsi approach. Methods From March 2017 to January 2019, 15 patients with closed calcaneal fractures were treated with the method of Steinmann pin retractor-assisted reduction and circle plate fixation via the sinus tarsi approach. All these patients received a positive postoperative clinical and radiological evaluation. Results A postoperative follow-up was done for each of the 15 patients, and the following scores and parameters were observed: value of visual analogue scale (VAS) was 1.44 ± 0.63, and The American Orthopaedic Foot and Ankle Score (AOFAS) Ankle-Hindfoot score was 84.31 ± 5.03 at the last follow-up. The Böhler angle (30.81 ± 3.56°), width (37.83 ± 4.87 mm), length (87.4 ± 3.33 mm), and height (86.23 ± 5.36 mm) of the calcaneus were improved significantly in comparison with preoperative values (− 0.94 ± 10.06°, 45.67 ± 5.68 mm, 82.72 ± 5.54 mm, 76.32 ± 7.98 mm), and these parameters were maintained excellently after 6–19 months’ follow-up. Conclusion Our present study suggested that Steinmann pin retractor-assisted reduction with circle plate fixation via the sinus tarsi approach may serve as a safe and effective method for Sanders type II and type III calcaneus fractures. The Böhler angle, height, length, and body of the calcaneus were excellently restored postoperatively and maintained at last follow-up and rare postoperative complications. Trial registration This study has been registered. The unique identifying number is research registry 5092.

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Plate fixation through the lateral extensile approach versus cannulated screw fixation through the sinus tarsi approach for calcaneal fracture: a multicenter, propensity score-matched TRON study

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-021-03115-9 ◽

2021 ◽

Author(s):

Takuya Sugimoto ◽

Katsuhiro Tokutake ◽

Yasuhiko Takegami ◽

Nobuyuki Okui ◽

Yasuhide Kanayama ◽

...

Keyword(s):

Propensity Score ◽

Screw Fixation ◽

Plate Fixation ◽

Calcaneal Fracture ◽

Cannulated Screw ◽

Sinus Tarsi ◽

Sinus Tarsi Approach ◽

Extensile Approach

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

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000418 ◽

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.

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

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00278 ◽

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.

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