Similar Anatomical Reduction and Lower Complication Rates With the Sinus Tarsi Approach Compared With the Extended Lateral Approach in Displaced Intra-Articular Calcaneal Fractures

Schepers, Tim; Backes, Manouk; Dingemans, Siem A.; Jong, Vincent M. de; Luitse, Jan S. K.

doi:10.1097/bot.0000000000000819

Cited by 53 publications

(43 citation statements)

References 32 publications

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“…It may be speculated, that many of those patients with simple Sanders Type 2 fractures could have been treated with percutaneous or less invasive methods that could have resulted in superior function and less soft-tissue complications. 55 56 57 58 59 Therefore, comparative trials should also include those patients with severe injuries.…”

Section: What Is the Current Evidence?mentioning

confidence: 99%

“… 74 79 Recent comparative studies show reduced rates of soft-tissue complications while achieving and maintaining adequate reduction. 58 76 80 …”

Section: Choice Of Approachesmentioning

confidence: 99%

“…Minimally-invasive fixation of calcaneal fractures significantly reduces the risk of soft-tissue complications. 55 56 57 58 74 80 Many authors consider percutaneous reduction and screw fixation in cases of extraarticular and simple intraarticular fractures with the posterior facet being displaced as a whole as in Sanders Type IIC fractures. 55 81 These techniques can be extended to intraarticular fractures with only 1 displaced fracture line across the subtalar joint (i.e., Sanders Types IIA and IIB) with proper control of the articular reduction with subtalar arthroscopy or three-dimensional (3D) fluoroscopy.…”

Section: Choice Of Approachesmentioning

confidence: 99%

“…The reported rates of superficial wound edge necroses range between 2% and 30% of all cases after osteosynthesis through an extended lateral approach, 15 18 21 23 58 61 75 87 88 89 between 0% and 12% the use of a sinus tarsi approach, 58 74 76 78 80 and between 0% and 6% with percutaneous fixation. 55 82 83 90 91 Further approaches are available for specific fracture patterns.…”

Section: Choice Of Approachesmentioning

confidence: 99%

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Calcaneal Fractures — Should We or Should We not Operate?

Rammelt

Sangeorzan

Swords

2018

IJOO

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The best treatment for displaced, intraarticular fractures of the calcaneum remains controversial. Surgical treatment of these injuries is challenging and have a considerable learning curve. Studies comparing operative with nonoperative treatment including randomized trials and meta-analyses are fraught with a considerable number of confounders including highly variable fracture patterns, soft-tissue conditions, patient characteristics, surgeon experience, limited sensitivity of outcome measures, and rehabilitation protocols. It has become apparent that there is no single treatment that is suitable for all calcaneal fractures. Treatment should be tailored to the individual fracture pathoanatomy, accompanying soft-tissue damage, associated injuries, functional demand, and comorbidities of the patient. If operative treatment is chosen, reconstruction of the overall shape of the calcaneum and joint surfaces are of utmost importance to obtain a good functional result. Despite meticulous reconstruction, primary cartilage damage due to the impact at the time of injury may lead to posttraumatic subtalar arthritis. Even if subtalar fusion becomes necessary, patients benefit from primary anatomical reconstruction of the hindfoot geometry because in situ fusion is easier to perform and associated with better results than corrective fusion for hindfoot deformities in malunited calcaneal fractures. To minimize wound healing problems and stiffness due to scar formation after open reduction and internal fixation (ORIF) through extensile approaches several percutaneous and less invasive procedures through a direct approach over the sinus tarsi have successfully lowered the rates of infections and wound complications while ensuring exact anatomic reduction. There is evidence from multiple studies that malunited displaced calcaneal fractures result in painful arthritis and disabling, three-dimensional foot deformities for the affected patients. The poorest treatment results are reported after open surgical treatment that failed to achieve anatomic reconstruction of the calcaneum and its joints, thus combining the disadvantages of operative and nonoperative treatment. The crucial question, therefore, is not only whether to operate or not but also when and how to operate on calcaneal fractures if surgery is decided.

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Section: What Is the Current Evidence?mentioning

confidence: 99%

“… 74 79 Recent comparative studies show reduced rates of soft-tissue complications while achieving and maintaining adequate reduction. 58 76 80 …”

Section: Choice Of Approachesmentioning

confidence: 99%

Section: Choice Of Approachesmentioning

confidence: 99%

Section: Choice Of Approachesmentioning

confidence: 99%

See 2 more Smart Citations

Calcaneal Fractures — Should We or Should We not Operate?

Rammelt

Sangeorzan

Swords

2018

IJOO

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“…In an attempt to lower the complication rate, various minimally invasive techniques have been introduced recently 13 , 14 . As one of the most widely applied minimally invasive techniques, the sinus tarsi approach has the advantage of direct visualization of the posterior articular facet and fewer wound-related complications 15 .…”

Section: Introductionmentioning

confidence: 99%

A minimally invasive (sinus tarsi) approach with percutaneous K-wires fixation for intra-articular calcaneal fractures in children

Tong¹,

et al. 2018

Journal of Pediatric Orthopaedics B

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The aim of this study was to analyze the management of displaced intra-articular calcaneal fractures in children at our pediatric orthopedic and to determine the results following open reduction via minimally invasive sinus tarsi approach and fixation with Kirschner wires (K-wires). Overall, 25 available cases of calcaneal fractures in children with mean age of 9.8 years were treated by open reduction from January 2010 to December 2015. All patients were followed up from 12 to 30 months (mean: 19 months). Clinical functional outcomes were graded using the American Orthopedic Foot and Ankle Society hindfoot scores. Radiographic evaluation included measurement of the Bohler’s angle and Gissane’s angle of the calcaneus on the lateral view. All fractures healed within 3 months. According to the American Orthopedic Foot and Ankle Society foot scoring system, the mean scores of type II fractures were 92.7±2.1, type III 90.2±1.8, and type IV 89.7±2.7 at the latest follow-up. The preoperative and postoperative Bohler’s angles were 17.1°±10.7° and 35.9°±6.7° in Sanders type II fractures, 14.4°±11.5° and 34.7°±8.5° in type III, 9.3°±9.7° and 35.1°±4.9° in type IV, respectively. The preoperative and postoperative Gissane’s angles were 102.6°±11.5° and 125.7°±7.8° in Sanders type II fractures, 101.7°±9.1° and 117.5°±10.8° (P<0.05) in type III, and 104.7°±5.1° and 122.8°±9.1° (P<0.05) in type IV, respectively. No secondary arthrosis has been observed so far. No deep infection and wound necrosis occurred. One patient had superficial infection around K-wires that was managed using dressings. Treatment of calcaneal fractures in children by open reduction by sinus tarsi approach and K-wires fixation is a safe and effective method with low incidence of complications.

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Calcaneal Fractures

Buckley

2021

Evidence‐Based Orthopedics

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Similar Anatomical Reduction and Lower Complication Rates With the Sinus Tarsi Approach Compared With the Extended Lateral Approach in Displaced Intra-Articular Calcaneal Fractures

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 53 publications

References 32 publications

Calcaneal Fractures — Should We or Should We not Operate?

Calcaneal Fractures — Should We or Should We not Operate?

A minimally invasive (sinus tarsi) approach with percutaneous K-wires fixation for intra-articular calcaneal fractures in children

Calcaneal Fractures

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