Sinus Tarsi Versus Extended Lateral Approach for Displaced Intra-Articular Calcaneal Fractures: A Single Surgeon's...

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Foot and ankle surgery

Background:

• Displaced intra-articular calcaneus fractures require surgical intervention.
• The extensile lateral (EL) and sinus tarsi (ST) approaches are surgical options.
• Comparing these approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the extensile lateral (EL) and sinus tarsi (ST) approaches for treating displaced intra-articular calcaneus fractures.
• To evaluate differences in surgical timing, operative time, and fracture reduction quality.
• To assess postoperative complications and the need for re-operation.

Main Methods:

• Retrospective cohort study of 129 calcaneus fractures treated by a single surgeon.
• Comparison of EL versus ST surgical approaches.
• Analysis of outcomes including time to surgery, operative time, Gissane angle restoration, wound complications, and re-operation rates.

Main Results:

• No significant differences in patient demographics, injury mechanisms, or fracture patterns between groups.
• The ST approach showed significantly shorter time to fixation and operative time (P < .00001).
• The EL approach had a small, significant improvement in the Gissane angle (3 degrees, P = .025), but both were within normal ranges.

Conclusions:

• The limited open ST approach is associated with reduced time to fixation and operative time for calcaneus fractures.
• The EL approach offers a slight advantage in Gissane angle restoration.
• The ST approach may facilitate earlier surgery with comparable reduction quality to the EL approach.