Jin Park1,2, Jin Ho Che3. 1. Department of Orthopedic Surgery, Yonsei Knee and Spine Hospital, 568, Cheonho-daero, Gwangjin-gu, Seoul, 04985, Republic of Korea. parkjinos@gmail.com. 2. Department of Orthopedic Surgery, College of Medicine, Catholic Kwandong University, International St. Mary's Hospital, 25, Simgok-ro 100 Beon-gil, Seo-gu, Incheon, 22711, Republic of Korea. parkjinos@gmail.com. 3. Department of Orthopedic Surgery, Yonsei Knee and Spine Hospital, 568, Cheonho-daero, Gwangjin-gu, Seoul, 04985, Republic of Korea.
Abstract
INTRODUCTION: Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. METHODS: Forty-seven consecutive patients with intra-articular calcaneal fractures treated using the sinus tarsi approach between March 2010 and April 2015 were retrospectively reviewed. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated. RESULTS: The mean one-year postoperative VAS and AOFAS scores were 0.54 (range 0-3.0), and 94.0 (range 80-100), respectively. The VAS and AOFAS scores were correlated with the degree of reduction of the posterior facet joint and the amount of Bohler angle restoration. Bony union was achieved in every case. The mean union time was 3.2 months (range 3-4 months). There were no major soft tissue complications. Three cases of minor soft tissue complications healed with no need for subsequent procedures. Painful hardware at the posterior calcaneal tuberosity was the most common complication, which occurred in seven cases. CONCLUSIONS: The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. Level of evidence IV.
INTRODUCTION: Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. METHODS: Forty-seven consecutive patients with intra-articular calcaneal fractures treated using the sinus tarsi approach between March 2010 and April 2015 were retrospectively reviewed. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated. RESULTS: The mean one-year postoperative VAS and AOFAS scores were 0.54 (range 0-3.0), and 94.0 (range 80-100), respectively. The VAS and AOFAS scores were correlated with the degree of reduction of the posterior facet joint and the amount of Bohler angle restoration. Bony union was achieved in every case. The mean union time was 3.2 months (range 3-4 months). There were no major soft tissue complications. Three cases of minor soft tissue complications healed with no need for subsequent procedures. Painful hardware at the posterior calcaneal tuberosity was the most common complication, which occurred in seven cases. CONCLUSIONS: The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. Level of evidence IV.
Entities:
Keywords:
Calcaneus fracture; Limited lateral approach; Screwing; Sinus tarsi approach
Authors: Christian Rodemund; Ronny Krenn; Carl Kihm; Iris Leister; Reinhold Ortmaier; Werner Litzlbauer; Angelika M Schwarz; Georg Mattiassich Journal: BMC Musculoskelet Disord Date: 2020-11-14 Impact factor: 2.362