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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
Je-Hyoung Yeo, Hyun-Jong Cho, Keun-Bae Lee
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JHY participated in its design and analyzed patient’s data and wrote the article. KBL conceived of the study and participated in its design and coordination, carried out the operations and helped to write the manuscript. HJC carried out statistical analysis and involved in the interpretation of the data. All authors read and approved the final manuscript.

Abstract

Background

Two common surgical approaches included the sinus tarsi and extensile lateral are used for displaced intra-articular calcaneal fractures. However, few studies have compared outcome of treated by the two approaches. The purpose of this study was to compare the outcome between these two approaches for Sanders type-II and type-III fractures.

Methods

This retrospective cohort study was performed from 2004 to 2011. Open reduction and internal fixation using the sinus tarsi and extensile lateral approach was studied in 100 cases (40 sinus tarsi and 60 extensile lateral) with displaced intra-articular calcaneal fractures. All patients were evaluated both clinically and radiologically.

Results

Median Böhler and Gissane angle were improved to 26.5 degree (4.6 to 45), 115.5 degree (101.2 to 127.4) in the sinus tarsi group and 25.3 degree (3.7 to 44.6), 119.0 degree (73.5 to 145.6) in extensile lateral group at the final follow-up, respectively. Median calcaneal height, length, and width in the sinus tarsi and extensile lateral groups showed improvement to 45.1 mm (23.2 to 54.1), 75.9 mm (64.9 to 90.3), 37.6 mm (29.2 to 53.9) and 46.5 mm (32.7 to 59.5), 76.1 mm (67.3 to 97.9), 39.3 mm (29.2 to 47.8) at the final follow-up, respectively. Median AOFAS score was checked to 90 points (76 to 94) in the sinus tarsi group and 86 points (76 to 94) in the extensile lateral group at the final follow-up. No significant differences in clinical and radiologic outcomes were observed between the two groups. However, wound complication rate (13.3%) in the extensile lateral group was significantly higher compared to the sinus tarsi group (p-value = 0.022).

Conclusions

The final clinical and radiographic outcomes between the two approaches for Sanders type-II and type-III intra-articular calcaneal fractures were comparable and equally successful. The selective sinus tarsi approach appears to be an effective and reliable method for the treatment of Sanders type-II and type-III fractures.
Literatur
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