Less wound complications of a sinus tarsi approach compared to an extended lateral approach for the treatment of displaced intraarticular calcaneal fracture

Li, Lianhua; Guo, Yongkang; Wang, Hao; Sang, Qing-Hua; Zhang, Jianzheng; Li, Zhi; Sun, Chuiguo

doi:10.1097/md.0000000000004628

Cited by 52 publications

(34 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reported complications rate related to calcaneus varied quite widely according to literature. Rate of complications for the ELA ranged from 3.5% to 31.2% and from 5% to 8.49% for the STA . Complication rate of 3.5% in 57 Sanders type III calcaneal fractures treated with ELA was reported by Cao et al George et al even reported that they had never encountered any wound dehiscence, or wound infection during an 18‐year period using a minimally invasive approach for ORIF for DIACFs .…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Lateral bone flap approach for displaced intra‐articular calcaneus fractures

Wang

Zhou

Liang

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: The traditional extended lateral approach for calcaneus fractures can provide sufficient exposure for reduction, but complications are frequent. The minimally invasive approach does limited damage to the soft tissue and its complication rate is low, but provides limited surgical exposure for complicated fracture. Thus, an approach that could provide wide exposure with less soft tissue injury is important. Methods: The lateral bone flap approach, we proposed, involved the same incision as the extended lateral approach. After incision, osteotomy was performed around the lateral bulged wall of the calcaneus without dissection of soft tissue. The lateral wall was free from calcaneus and connected with the soft tissue, and the lateral bone flap was developed. The reduction of fracture and the fixation of plate were performed as usual. Next, the bone flap was reduced and sutured. This retrospective study of lateral bone flap approach included 63 cases of 58 patients with displaced intra-articular calcaneus fractures from January 2011 to January 2015. Clinical and radiological outcomes and complications were all recorded. Results: Radiological outcome was significantly improved at 3 months and 2 years postoperatively compared with that of pre-operatively (P < 0.01). The Maryland Foot Score at the last follow up was 87.2 AE 7.0. The excellent/good rate was 90.5%. One case of delayed wound healing occurred. No infection or sural nerve injury occurred. Conclusion: The lateral bone flap approach is simple, safe and effective for displaced intraarticular calcaneus.

show abstract

Section: Discussionmentioning

confidence: 93%

“…The ELA is the gold standard of operative approach for calcaneus fractures and is applied for any type of Sanders fracture. However, the rate of complications, including infection, dehiscence and skin necrosis was high and was reported to range from 13.3% to 31.2% …”

Section: Discussionmentioning

confidence: 99%

Lateral bone flap approach for displaced intra‐articular calcaneus fractures

Wang

Zhou

Liang

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Several authors have reported good clinical and radiographic results for this approach and a low incidence of complications although studies vary with respect to approach site, length of incision, and fixation method 41718192021222829303132. In addition, in the majority of studies, the accuracy of posterior facet reduction was evaluated using Böhler's and Gissane's angles in plain radiographs.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Sanders Type 2 Calcaneal Fractures Using a Sinus Tarsi Approach

Park

Lee

2017

IJOO

View full text Add to dashboard Cite

Background:Calcaneum is the most commonly fractured tarsal bone. The optimal treatment for displaced calcaneus fractures involving the posterior facet is surgical. The extensile lateral approach is commonly preferred because it provides sufficient exposure of the subtalar facet. However, this technique has the risk of complications such as wound necrosis and sural nerve injury. Various minimally invasive approaches, such as sinus tarsi approach, limited posterior approach, and percutaneous approach, have been introduced to reduce possible complications. This study was prospectively performed to evaluate the results of the sinus tarsi approach for Sanders Type 2 calcaneal fractures using postoperative computed tomography (CT).Materials and Methods:Between October 2012 and December 2013, 20 Sanders Type 2 calcaneal fractures were consecutively treated using a sinus tarsi approach and checked using CT preoperatively, immediately postoperatively, and at 12 months after surgery. Clinical evaluations were performed using the visual analog scale (VAS) and the ankle-hindfoot score developed by the American Orthopaedic Foot and Ankle Society (AOFAS). Radiographic evaluations were performed using calcaneus lateral and axial radiographs, hindfoot alignment radiograph, and CT. Changes in Böhler's angles and calcaneal widths were evaluated both preoperatively and at last followup. Reduction of the posterior facet was graded according to articular step, defect, and angulation of the posterior facet in CT.Results:VAS and AOFAS scores were significantly improved at 1 year after surgery but did not improve further. Böhler's angles and calcaneal widths were significantly improved after surgery. Böhler's angle was significantly smaller at the last followup than immediately after surgery, whereas calcaneal width was maintained. Reduction of the posterior facet was graded excellent in five feet (25%), good in ten (50%), and fair in five (25%) on immediately postoperative CT. Two feet (10%) had transient sural nerve injury which resolved within 3 months. Five feet (20%) had subfibular pain due to a prominent screw heads.Conclusion:Surgical management using a sinus tarsi approach produced good clinical and radiographic results and low wound complications for Sanders type 2 calcaneal fractures. It is important to have stable fixation and to achieve sufficient reduction of calcaneal width for the prevention of loss of reduction and lateral subfibular impingement.

show abstract

“…The primary concern with this approach is a high complication rate. [36][37][38][39][40][41][42][43] Some techniques can be employed to decrease the risk of complications related to this approach. For example, the corner of the incision should be curved to avoid significant wound complications.…”

Section: Conservative Treatment Vs Open Reduction and Internal Fixationmentioning

confidence: 99%

“…Minimally invasive techniques have been proposed for displaced intra-articular calcaneal fractures with the aim of potentially lowering wound complication rates and improving overall outcomes. 42,61 Various minimally invasive approaches, such as the Palmer approach, 34 Smile incision, 62 Ollier approach, 63 sinus tarsi approach, 46,64,65 and minimally invasive longitudinal approach, 66 have been introduced to minimize the wound complication rate.…”

Section: Internal Fixation Of Displaced Intraarticular Calcaneal Fracmentioning

confidence: 99%

Displaced Intra-articular Calcaneal Fractures: Classification and Treatment

Wei¹,

Zhou²,

Chang³

et al. 2017

Orthopedics

View full text Add to dashboard Cite

The calcaneus is the most commonly fractured tarsal bone. Displaced intraarticular calcaneal fractures are usually caused by a fall from height with one or both heels directly hitting the ground. Displaced intra-articular calcaneal fractures are complex and highly disabling injuries. There is ongoing debate regarding the optimal treatment for each type of displaced intra-articular calcaneal fracture. This review aims to summarize the classification of, various treatment options for, prevention of perioperative complications in, and management algorithms for displaced intra-articular calcaneal fractures. [Orthopedics. 2017; 40(6):e921-e929.].

show abstract

Less wound complications of a sinus tarsi approach compared to an extended lateral approach for the treatment of displaced intraarticular calcaneal fracture

Cited by 52 publications

References 18 publications

Lateral bone flap approach for displaced intra‐articular calcaneus fractures

Lateral bone flap approach for displaced intra‐articular calcaneus fractures

Surgical Treatment of Sanders Type 2 Calcaneal Fractures Using a Sinus Tarsi Approach

Displaced Intra-articular Calcaneal Fractures: Classification and Treatment

Contact Info

Product

Resources

About