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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Sinus Tarsi Versus Extensile Lateral Approach For Calcaneal Fractures - A Multicenter Study.

Thomas M Seaver1, Zachary Zeller, Paul Tornetta

  • 1From the Department of Orthopedic Surgery, Boston University Medical Center, Boston, MA (Dr. Zeller and Dr. Tornetta); the Lahey Medical Center, Department of Orthopedic Surgery, Burlington, MA (Dr. Marcantonio and Mr. Ment); Department of Orthopedic Surgery, the Florida Orthopaedic Institute, Tampa, FL (Dr. Mir and Dr. McCaskey); Department of Orthopedic Surgery, the University of Alabama at Birmingham, Birmingham, AL (Dr. Messner and Dr. Spitler); Department of Orthopedic Surgery, the Washington University in St. Louis, St Louis, MO (Dr. Hofer and Dr. Miller); the Hennepin County Medical Center, Minneapolis, MN (Mr. Westberg and Dr. Downes), Department of Orthopedic Surgery; Department of Orthopedic Surgery, the Metro Health Medical Center, Cleveland, OH (Dr. Joseph); Department of Orthopedic Surgery, the University of North Carolina, Chapel Hill, NC (Dr. Suh and Dr. Ostrum); Department of Orthopedic Surgery, the University of Nottingham, Nottingham, UK (Dr. Ollivere and Dr. Ikram); Department of Orthopedic Surgery, the Indiana University, Indianapolis, IN (Dr. Mullis and Dr. Figueras); Department of Orthopedic Surgery, the Oregon Health Science University, Portland, OR (Dr. Friess and Ms. Sodders); Department of Orthopedic Surgery, the Stanford University, Palo Alto, CA (Dr. Van Rysselberghe and Dr. Gardner); Department of Orthopedic Surgery, the Stony Brook University, Stony Brook, NY (Dr. Pawlak and Dr. Kottmeier); Department of Orthopedic Surgery, the University of California San Francisco, San Francisco, CA (Dr. Morshed); Department of Orthopedic Surgery, the Harborview Medical Center, Seattle, WA (Dr. Goodnough, Dr. Bunzel, and Dr. Firoozabadi); Department of Orthopedic Surgery, the University of Minnesota, Minneapolis, MN (Dr. Yoon and Mr. Pottinger); Department of Orthopedic Surgery, the Case Western Reserve University, Cleveland, OH (Dr. Vallier); Department of Orthopedic Surgery, the Hughston Clinic, Nashville, TN (Dr. Hofer); Department of Orthopedic Surgery, the SUNY Downstate Health Sciences University, Brooklyn, NY (Dr. Malik); Department of Orthopedic Surgery, the Orillia Soldiers' Memorial Hospital, Orillia, Canada (Dr. Lim); Department of Orthopedic Surgery, the University of Arizona, Phoenix, AZ (Dr. Johnson and Mr. Chaliki); and the Sanford Medical Center, Department of Orthopedic Surgery, Fargo, ND (Dr. Seaver).

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
|November 4, 2025
PubMed
Summary
This summary is machine-generated.

The sinus tarsi (ST) surgical approach for calcaneal fractures shows lower deep infection rates compared to the extended lateral (EL) approach. This finding aids in selecting optimal surgical techniques for better patient outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Surgical Outcomes Research

Background:

  • Intraarticular calcaneal fractures present complex treatment challenges.
  • Surgical management options, including extended lateral (EL) and sinus tarsi (ST) approaches, are debated.
  • Deep infection is a significant complication following surgical repair.

Purpose of the Study:

  • To compare the incidence of deep surgical site infections between the extended lateral (EL) and sinus tarsi (ST) approaches for intraarticular calcaneal fractures.
  • To identify independent risk factors for deep infection in surgically treated calcaneal fractures.

Main Methods:

  • Retrospective review of 782 patients with OTA 82B/C calcaneal fractures from 15 institutions.
  • Deep infection defined as requiring surgical débridement or osteomyelitis treatment.
  • Univariate and multivariate analyses to identify risk factors.

Main Results:

  • 444 fractures treated with EL, 338 with ST.
  • Deep infection rates: 6.8% for EL vs. 3.0% for ST (P=0.017).
  • Independent risk factors included surgical approach (P=0.03) and patient age (P<0.001). EL had more wound complications; ST had more symptomatic implants.

Conclusions:

  • The sinus tarsi (ST) approach is associated with significantly lower deep infection rates compared to the extended lateral (EL) approach.
  • ST approach also demonstrated fewer wound complications.
  • The ST approach may be preferable for managing intraarticular calcaneal fractures, including in higher-risk individuals.