Surgeon Learning Curve for the Sinus Tarsi Approach to Intra-articular Calcaneus Fractures: Improvement With...

Area of Science:

• Orthopaedic Surgery
• Trauma Surgery
• Surgical Outcomes Research

Background:

• Displaced intra-articular calcaneus fractures are complex injuries requiring precise surgical reduction.
• The sinus tarsi approach (STA) is a surgical technique used for these fractures.
• Surgeon experience is hypothesized to influence patient outcomes in complex orthopedic procedures.

Purpose of the Study:

• To investigate the correlation between surgeon experience with the sinus tarsi approach (STA) and treatment outcomes for displaced intra-articular calcaneus fractures.
• To quantify the impact of cumulative surgical experience on reduction quality and complication rates.

Main Methods:

• Retrospective analysis of 103 consecutive patients undergoing open reduction via STA for OTA/AO 82C (Sanders II-IV) calcaneus fractures.
• Surgeons included two fellowship-trained orthopaedic traumatologists.
• Outcomes assessed by postoperative CT and radiographs for reduction quality; complications were meticulously recorded.

Main Results:

• A total of 66 patients met inclusion criteria, predominantly male (75.8%) with a mean age of 41.
• Good or excellent reduction quality was achieved in 84.9% of cases.
• Each year of surgeon experience with STA correlated with a 29.3% reduction in surgical complications (P < 0.001).
• Increased experience also significantly improved the likelihood of achieving good or excellent reduction (P = 0.012 and P = 0.007, respectively).

Conclusions:

• Surgeon experience is a critical determinant of successful outcomes in treating displaced intra-articular calcaneus fractures using the STA.
• Both the number of cases performed and years of experience with the STA positively impact reduction quality and reduce complication rates.