Sinus Tarsi Approach for Sanders Type IV Calcaneal Fractures: Midterm Radiographic, Functional and Complication...

Area of Science:

• Orthopedic surgery
• Traumatology
• Foot and ankle surgery

Background:

• Sanders type IV calcaneal fractures present significant comminution and often lead to poor patient outcomes.
• The efficacy of the sinus tarsi approach for these severe fractures is not well-established.

Purpose of the Study:

• To assess radiographic restoration, functional recovery, and complication rates following the sinus tarsi approach in patients with Sanders type IV calcaneal fractures.

Main Methods:

• A retrospective case series of 51 patients with Sanders type IV calcaneal fractures treated via the sinus tarsi approach.
• Radiographic measurements (Böhler angle, Gissane angle, calcaneal height/length) were evaluated preoperatively, early postoperatively, and at final follow-up (minimum 24 months).
• Functional outcomes were assessed using the visual analog scale (VAS) for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, alongside complication and reoperation tracking.

Main Results:

• Significant improvements in all measured radiographic parameters were observed post-surgery (p < 0.001).
• The mean Böhler angle improved from -6.4° preoperatively to 20.4° at final follow-up.
• Median final VAS was 2, and the median AOFAS score was 81, with a 14% reoperation rate and no deep infections, malunions, or nonunions.

Conclusions:

• The sinus tarsi approach demonstrates satisfactory midterm radiographic and functional results for Sanders type IV calcaneal fractures.
• Complication and reoperation rates were deemed acceptable in this series.
• Further prospective comparative research is recommended to solidify the role of the sinus tarsi approach for these complex fractures.