Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 8

Minimally Invasive Sinus Tarsi Approach for Displaced Intra- Articular Calcaneal Fractures

Randhawa SS*, Lee KJ, Ewe Benny, Thong FY, Gurmeet S and Ibrahim MI M

Department of Orthopaedics, Hospital Tengku Ampuan Rahimah, Klang, Malaysia

*Corresponding Author: Randhawa SS, Department of Orthopaedics, Hospital Tengku Ampuan Rahimah, Klang, Malaysia.

Received: June 26, 2023; Published: July 28, 2023

Abstract

Introduction: Operative treatment of displaced intra- articular calcaneum fractures remain challenging and are associated with a high rate of wound complications. Extensile lateral approach (ELA) is most commonly used and is associated with a high rate of wound related complications, deep infection and sural nerve injuries. A minimally invasive sinus tarsi approach for displaced intra- articular calcaneus fractures can be used to achieve fracture reduction and fixation as well as minimize wound healing complications. The purpose of this prospective observational case series study is to report clinical and radiological outcomes associated with the sinus tarsi approach in the treatment of displaced intra- articular calcaneal fractures.

Methods: Fifteen intra- articular fractures in 14 patients with displaced fractures were managed surgically between February 2020 and December 2021. Demographic and radiographic data were collected for all patients including, age, gender, smoking status, presence of diabetes, mechanism of injury, injury side, time to surgery, length of hospital stay, follow up duration, Sanders classification, Bohler and Gissane. Post- operatively we recorded clinical evaluations for wound healing complications, deep infections, sural nerve injuries, peroneal tendinitis, time taken to return to work after the injury, and radiographic measurements.

Results: Fifteen intra- articular calcaneum fractures in 14 patients with a mean age of 47.1 (range 28- 58) years underwent open reduction and internal fixation for displaced intra-articular calcaneus fractures. Using the Sanders classification, we identified 27% Type 2 and 73% Type 3. From this, 33% of fractures displaced had a negative Bohler’s angle, 47% had an angle 0° to 20° and 20% over 20°. Post- operatively, all patients had an improvement in Bohler’s angle with 33% with 0° to 20° and 67% over 20°. The angle of Gissane measured pre- operatively averaged 100.9° and the average post- operative angle was 120°. Approximately, 50% of the patients working prior to the injury had returned to work by 6 months and 80% by 9 months. Bony union was achieved in all cases. There were no cases of wound related complications such as superficial or deep infection.

Conclusion: Calcaneal Fractures; Minimally Invasive; Sinus Tarsi Approach.

Keywords: Periprosthetic Humeral Fracture; Allograft; PFPH

References

  1. Weinraub GM and David MS. “Sinus Tarsi Approach with Subcutaneously Delivered Plate Fixation for Displaced Intra-Articular Calcaneal Fractures”. Clinics in Podiatric Medicine and Surgery 2 (2019): 225-231.
  2. Rammelt S., et al. “Calcaneal Fractures - Should We or Should We not Operate?” Indian Journal of Orthopaedics 3 (2018): 220-230.
  3. Khazen G and Rassi CK. “Sinus Tarsi Approach for Calcaneal Fractures: The New Gold Standard?” Foot and Ankle Clinics 4 (2020): 667-681.
  4. Pearce CJ., et al. “Calcaneal fractures: selection bias is key”. The Bone and Joint Journal 97-B.7 (2015): 880-882.
  5. Bèzes H., et al. “The operative treatment of intraarticular calcaneal fractures. Indications, technique, and results in 257 cases”. Clinical Orthopaedics and Related Research 290 (1993): 55-59.
  6. Buckley R., et al. “Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial”. The Journal of Bone and Joint Surgery. American Volume 10 (2002): 1733-1744.
  7. Bajammal S., et al. “Displaced intra-articular calcaneal fractures”. Journal of Orthopaedic Trauma 5 (2005): 360-364.
  8. Veltman ES., et al. “Long- term outcomes of 1,730 calcaneal fractures: systematic review of the literature”. The Journal of Foot and Ankle Surgery 4 (2013): 486-490.
  9. Kikuchi C., et al. “Limited sinus tarsi approach for intra- articular calcaneus fractures”. Foot and Ankle International 12 (2013): 1689-1694.
  10. Nosewicz TL., et al. “A systematic review and meta-analysis of the sinus tarsi and extended lateral approach in the operative treatment of displaced intra-articular calcaneal fractures”. Foot and Ankle Surgery 5 (2019): 580-588.
  11. Schepers T. “The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review”. International Orthopaedics 5 (2011): 697-703.
  12. Davey MS., et al. “Evaluating Short-Term Outcomes Post-Intra-Articular Calcaneal Fracture Fixation via a Sinus Tarsi Approach in a Non-Exclusively Selected Cohort”. The Journal of Foot and Ankle Surgery 2 (2021): 302-306.
  13. Yeo JH., et al. “Comparison of two surgical approaches for displaced intra- articular calcaneal fractures: sinus tarsi versus extensile lateral approach”. BMC Musculoskeletal Disorders 16 (2015): 63.
  14. Hospodar P., et al. “Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach”. Orthopedics11 (2008): 1112.

Citation

Citation: Randhawa SS., et al. “Minimally Invasive Sinus Tarsi Approach for Displaced Intra- Articular Calcaneal Fractures".Acta Scientific Orthopaedics 6.8 (2023): 103-107.

Copyright

Copyright: © 2023 Randhawa SS., et al. 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.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US