TA Al-Sadek¹ and A Al-Sadek²

¹Trakia University, Medical college - Stara Zagora, Bulgatria
²UMHAT Tsaritsa Joanna- ISUL, Department of Orthopedics and Traumatology- Sofia, Bulgaria

*Corresponding Author: TA Al-Sadek, Trakia University, Medical college - Stara Zagora, Bulgatria.

Received: January 23, 2023; Published: March 07, 2023

Abstract

Objective: To evaluate the results of fixation of intra articular calcaneus fracture using sinus tarsi approach, bone block substitute, and screws fixation.

Background: Minimal invasive techniques for treatment calcaneus fractures have been developed to overcome soft tissue complications associated with the traditional lateral approach. Sinus tarsi approach has the advantage of visualization of posterior facet of subtalar joint.

Methods: All patients underwent preoperative calcaneal lateral and axial radiographs and CT scan of the injured foot. The injury type was graded according to the Sanders classification on the basis of the CT scan findings. Bohler and Gissane angles were measured as anatomical parameters before surgery. Sinus tarsi approach was done for all patients, in addition to use of percutaneous screws fixation and bone block graft substitute.

Results: A total of 14 patients were included in our study. The mean age was 37.8years,at the end of follow up radiological evaluation was done by measuring ; Bohler angle and angle of Gissan. American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score was calculated at the end of follow-up for all the cases. Excellent results were found in7 patients, good results in 5 patients and fair results in only 2patients. There was statistically significant improvement of Bohler angle at the end of follow up.

Conclusion: Treatment of intra articular calcaneal fractures using sinus tarsi approach with a bone block substitute and screws can provide satisfactory clinical outcomes.

Keywords: Sinus Tarsi; Articular Calcaneus Fractures; Bone Block Substitute

References

1. Sanders R., et al. “Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification”. Clinical Orthopaedics and Related Research 290 (1993): 87-95.
2. Thordarson DB and Krieger LE. “Operative versus nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial”. Foot and Ankle International 17 (1996): 2-9.
3. Kurozumi T., et al. “Open reduction for intraarticular calcaneal fractures: evaluation using computed tomography”. Foot and Ankle International 24 (2003): 942-948.
4. Paley D and Hall H. “Intra-articular fractures of the calcaneus. A critical analysis of results and prognostic factors”. Journal of Bone and Joint Surgery American Volume 75 (1993): 342-354.
5. Rammelt S., et al. “The value of subtalar arthroscopy in the management of intra-articular calcaneus fractures”. Foot and Ankle International 23 (2002): 906-916.
6. Buckley R., et al. “Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial”. Journal of Bone and Joint Surgery American Volume 84 (2002): 1733-1744.
7. Abidi N., et al. “Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures”. Foot and Ankle International 19 (1998): 856-861.
8. Benirschke SK and Kramer PA. “Wound healing complications in closed and open calcaneal fractures”. Journal of Orthopaedic Trauma1 (2004): 1-6.
9. Harvey EJ., et al. “Morbidity associated with ORIF of intra-articular calcaneus fractures using a lateral approach”. Foot and Ankle International11 (2001): 868-873.
10. Xia S., et al. “A minimally invasive sinus tarsi approach with percutaneous plate and screw fixation for intra-articular calcaneal fractures”. International Journal of Surgery10 (2013): 1087-1091.
11. Kikuchi C., et al. “Limited sinus tarsi approach for intra-articular calcaneus fractures”. Foot and Ankle International 12 (2013): 1689-1694.
12. Meraj A., et al. “Management of intraarticular calcaneal fractures by minimally invasive sinus tarsi approach-early results”. Malaysian Orthopaedic Journal1 (2012): 13-17.
13. Abdelazeem A., et al. “Management of displaced intra-articular calcaneal fractures using the limited open sinus tarsi approach and fixation by screws only technique”. International Orthopaedics 38 (2014): 601-606.
14. Tian H., et al. “Bone graft versus non-bone graft for treatment of calcaneal fractures: A protocol for meta-analysis”. Medicine 2 (2021): e24261.
15. Kitaoka HB., et al. “Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes”. Foot and Ankle International7 (1994): 349-353.
16. Lim EV and Leung JP. “Complications of intraarticular calcaneal fractures”. Clinical Orthopaedics and Related Research 391 (2001): 7-16.
17. Potter MQ and Nunley JA. “Long-term functional outcomes after operative treatment for intra-articular fractures of the calcaneus”. Journal of Bone and Joint Surgery American Volume8 (2009): 1854-1860.
18. Schepers T. “The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review”. International Orthopaedics 5 (2011): 697-703.
19. P Guzman., et al. “Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach”. Orthopedics 11 (2008): 1112.
20. Park J and Che HJ. “Sinus tarsi approach in displaced intra-articular calcaneal fractures”. Archives of Orthopaedic and Trauma Surgery 137 (2017): 1055-1065.
21. Mostafa MF., et al. “Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach”. Strategies in Trauma and Limb Reconstruction 2 (2010): 87-95.
22. Ho CJ., et al. “Open reduction and internal fixation of acute intra-articular displaced calcaneal fractures: a retrospective analysis of surgical timing and infection rates”. Injury 44 (2013): 1007-10.
23. Rammelt S and Zwipp H. “Calcaneus fractures: facts, controversies and recent developments”. Injury 35 (2004): 443-461.
24. Loucks C and Buckley R. “Bohler’s angle: Correlation with outcome in displaced intra-articular calcaneal fractures”. Journal of Orthopaedic Trauma 13 (1999): 554-558.
25. Wang Q., et al. “Minimally invasive treatment of calcaneal fracture by percutaneous leverage, anatomical plate, and compression bolts--the clinical evaluation of cohort of 156 patients”. Journal of Trauma 69 (2010): 1515-1522.
26. Su Y., et al. “Bohler’s angle’s role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study”. BMC Surgery 13 (2013): 40.
27. Zeng Z., et al. “Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: a meta-analysis of randomized controlled trials”. International Journal of Surgery 50 (2018): 146-153.
28. Park CH and Lee DY. “Surgical treatment of Sanders type 2 calcaneal fractures using a sinus tarsi approach”. Indian Journal of Orthopaedics 4 (2017): 461-467.
29. Zhan J., et al. “A modified tarsal sinus approach for intra-articular calcaneal fractures”. Journal of Orthopaedic Surgery 2 (2019): 1-7.

Citation

Citation: TA Al-Sadek and A Al-Sadek. “Is Using Sinus Tarsi Approach with Bone Block Susbstitute and Screws the Optimal Plan of Treatment of Articular Calcaneus Fracture?”. Acta Scientific Orthopaedics 6.4 (2023): 31-35.

Copyright

Copyright: © 2023 TA Al-Sadek and A Al-Sadek. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.