Sinus Tarsi Approach and Osteosynthesis with Cannulated Screws in Calcaneal Fractures with Articular Depression
Abstract
Introduction: Open reduction and internal fixation via an extended lateral approach is the most commonly accepted surgical strategy for managing intra-articular calcaneal fractures with articular depression. However, the high rate of soft tissue complications associated with this technique has led to the development of less invasive alternatives that aim to reduce complications and improve functional outcomes. Objective: To evaluate the complications and functional outcomes of calcaneal fracture fixation usingthe sinus tarsi approach and cannulated screws. Materials and Methods: Between June 2016 and June 2022, 14 intra-articular calcaneal fractures with articular depression were treated using the sinus tarsi approach and cannulated screw fixation. Postoperative complications, radiographic outcomes (Gissane angle, Böhler angle, calcaneal length and width), and CT findings (Sanders classification) were assessed, along with functional outcomes using the American Orthopaedic Foot & Ankle Society (AOFAS) score and a self-administered satisfaction questionnaire. Results: With a mean follow-up of 19.28 months, the average AOFAS score was 84.14. One superficial infection was reported and successfully treated with oral antibiotics. In two patients, hardware removal was required. Immediate and late postoperative imaging showed no significant differences compared to the contralateral healthy calcaneus. No postoperative articular step-offs greater than 2 mm were observed on CT scans. Eight patients reported being satisfied with the outcome, and six were very satisfied. Conclusion: The sinus tarsi approach combined with cannulated screw fixation provides functional and radiographic outcomes comparable to or better than those achieved with the extended lateral approach and lateral plating, with fewer soft tissue complications.Downloads
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