Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: A meta-analysis of randomized controlled trials

Zeng, Zhilin; Yuan, Ling-Mei; Zheng, Shengpeng; Sun, Youqiang; Huang, Feng

doi:10.1016/j.ijsu.2017.12.034

Cited by 47 publications

(50 citation statements)

References 28 publications

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“…Additionally, the total number of patients included in their meta-analysis was only 532 [ 19 ]. Zeng et al similarly completed a meta-analysis of minimally invasive versus extensile lateral approaches for Sanders type 2 and 3 calcaneal fractures but were only able to include 495 participants from eight randomised trials [ 20 ]. Lastly, Yao et al report a meta-analysis of 1078 participants on the topic and claim to have identified improved wound healing and functional outcomes associated with a sinus tarsi approach.…”

Section: Discussionmentioning

confidence: 99%

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Mehta

Phan

et al. 2018

J Orthop Surg Res

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BackgroundOperative management of displaced, intra-articular calcaneal fractures is associated with improved functional outcomes but associated with frequent complications due to poor soft tissue healing. The use of a minimally invasive sinus tarsi approach to the fixation of these fractures may be associated with a lower rate of complications and therefore provide superior outcomes without the associated morbidity of operative intervention.MethodsWe reviewed four prospective and seven retrospective trials that compared the outcomes from the operative fixation of displaced intra-articular calcaneal fractures via either an extensile lateral approach or minimally invasive fixation via a sinus tarsi approach.ResultsPatients managed with a sinus tarsi approach were less likely to suffer complications (OR = 2.98, 95% CI = 1.62–5.49, p = 0.0005) and had a shorter duration of surgery (OR = 44.29, 95% CI = 2.94–85.64, p = 0.04).ConclusionIn displaced intra-articular calcaneal fractures, a minimally invasive sinus tarsi approach is associated with a lower complication rate and quicker operation duration compared to open reduction and internal fixation via an extensile lateral approach.

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Section: Discussionmentioning

confidence: 99%

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Mehta

Phan

et al. 2018

J Orthop Surg Res

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“…The new operation method was simple and the surgery process was smooth, and a good postoperative effect was achieved. Moreover, the surgery time was just 28.16 ± 10.70 min as compared to > 60 min for classic calcaneal fracture MIIF and ORIF [17,29]. The operation was guided at each step by the PSI, which facilitated the surgical procedure and eliminated the need for extensive intraoperative fluoroscopy, resulting in near-perfect fracture reduction and internal fixation.…”

Section: Discussionmentioning

confidence: 99%

“…d Two posterior cannulated screws were inserted to fix the main body of the calcaneus axially 3-8 weeks, followed by partial weight bearing for several weeks according to the doctor's advice. Full weight bearing was allowed when radiographs showed evidence of osseous union, generally at 3 months post surgery [17,18].…”

Section: Postoperative Managementmentioning

confidence: 99%

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

Wang

et al. 2020

BMC Musculoskelet Disord

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Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan. Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSIassisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre-and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available. Results: Mean intraoperative fluoroscopy time was 3.95 ± 1.78 h; IFAU in 16 patients (16 ft) was the same as the preoperative plan; mean surgery time was 28.16 ± 10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre-and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2% ± 2.3%. AOFAS scores increased with time, with significant differences in the score at each time point. Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

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“…The new operation method was simple and the surgery process was smooth, and a good postoperative effect was achieved. Moreover, the surgery time was just 28.16±10.70 min as compared to >60 min for classic calcaneal fracture MIIF and ORIF [17,29]. The operation was guided at each step by the PSI, which facilitated the surgical procedure and eliminated the need for extensive intraoperative uoroscopy, resulting in near-perfect fracture reduction and internal xation.…”

Section: Discussionmentioning

confidence: 99%

“…Patients were encouraged to engage in non-weightbearing mobilization for the rst 3-8 weeks, followed by partial weight bearing for several weeks according to the doctor's advice. Full weight bearing was allowed when radiographs showed evidence of osseous union, generally at 3 months post surgery [17,18].…”

Section: Postoperative Managementmentioning

confidence: 99%

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

Wang

et al. 2020

Preprint

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Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan.Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available.Results: Mean intraoperative fluoroscopy time was 3.95±1.78 h; IFAU in 16 patients (16 feet) was the same as the preoperative plan; mean surgery time was 28.16±10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2%±2.3%. AOFAS scores increased with time, with significant differences in the score at each time point.Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

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Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: A meta-analysis of randomized controlled trials

Cited by 47 publications

References 28 publications

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

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