Treatments Using The Sinus Tarsi Approach And Hollow Screws In Sanders Type â…¡or â…¢ Calcaneal Fractures

Object iveTo evaluate the effectivity of treatments using the sinus tarsi approach and hollow screws in Sanders type â…¡ or â…¢ calcaneal fractures.MethodsA retrospective review of all intra-articular calcaneal fractures treated operatively between January2009and October2013had be perform. A total of99fractures were found that met our inclusion criteria;83were treated with an extensile lateral approach and plate fixation, and we selected28of them randomly;16via a sinus tarsi approach and hollow screws based on surgeon preference. Chart and radiographic results were thoroughly reviewed on all44fractures, specifically for wound healing complications and the need for further surgeries within the study period. Additionally, all patients were contacted and asked to return for a research visit that included radiography, clinical examination, Maryland Foot Score(MFS) and American Orthopaedic Foot&Ankle Society(AOFAS) Ankle Hindfoot Scale.ResultsThe2groups were comparable with regard to demographics (age, follow-up, male to female ratio, tobacco use etc.). In the extensile group,43%of fractures were Sanders â…¡ and57%were Sanders â…¢, whereas in the sinus tarsi approach group56%were Sanders â…¡ and44%were Sanders â…¢. The overall wound complication rate was10%in the extensile group (3.5%required operative intervention) versus none in the sinus tarsi approach group. In the sinus tarsi approach group,4of16(25%) complained of sural nerve symptoms versus none in the extensile group. In the group of patients who returned for research visits, the average Maryland Foot Score was83.6in the extensile group versus 88.1in the minimally invasive group (P=0.541). The average AOFAS Ankle Hindfoot Scale was79.8in the extensile group versus82.1in the minimally invasive group (P=0.909). Both groups had100%union rates, and no differences were noted in the final postoperative Bohler angle, angle of Gissane and Langre angle.ConclusionClinical results were similar between calcaneal fractures treated with an extensile approach and those treated with a sinus tarsi approach. However, the sinus tarsi approach had a significantly lower incidence of wound complications and secondary surgeries. The sinus tarsi approach was a valuable method for the treatment of type â…¡ or â…¢ calcaneal fractures, with low complication rates and results comparable to those treated with an extensile approach...