A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture

Abstract

Purpose:To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture. Materials and Methods: From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups. Results: There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications. Conclusion:The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

Meta‐analysis of two surgical approaches for calcaneal fractures: sinus tarsi versus extensile lateral approach

“…However, the advantages of STA over ELA are apparent, as reported in the literatures . The length of STA is 3–6 cm, obviously shorter than the ELA . The shorter incision decreased the loss of blood .…”

“…The ELA provides excellent visualization of the fracture site, allowing access to manipulation and rigid fixation of the injury and direct reduction of the displaced fracture fragment. However, several studies reported that the post‐operative wound complication rate of this technique, including wound edge necrosis, dehiscence, haematoma or deep infection, is high . To lower wound complications, the application of minimally invasive technology has been developed.…”

“…To lower wound complications, the application of minimally invasive technology has been developed. Over the past several years, external fixation, percutaneous fixation, arthroscopically assisted fixation and minimal incision techniques via medial, lateral, posterior or combined approaches were described in the literature . These techniques all attempt to minimize soft tissue trauma to reduce the risk of operative complications, while still allowing good fracture reduction.…”

“…Several studies have compared the clinical outcomes of the ELA and STA . However, they were limited by the smaller sample size, the fewer observational items and the reported inconsistent results.…”

Extensile lateral versus sinus tarsi approach for calcaneal fractures

“…However, ELA can also damage the blood supply to the corners of the L-shaped flap, causing complications such as wound edge necrosis, nerve damage, and infection. [12][13][14] To this end, clinical researchers have developed several smallincision, minimally invasive reduction techniques. [15] The most common of these is the sinus tarsi approach (STA), which is performed through a small incision in the distal fibula that is anterior to the fibular tendon.…”