Acute Fixation of Displaced Intra-articular Calcaneus Fractures Is Safe Using the Sinus Tarsi Approach

Joseph, Noah M; Benedick, Alex; McMellen, Christopher J; Napora, Joshua K.; Wetzel, Robert J.; Sontich, John K.; Ochenjele, George

doi:10.1097/bot.0000000000002085

Cited by 8 publications

(5 citation statements)

References 35 publications

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“…This relationship between fracture severity and development of symptomatic posttraumatic arthritis is well-documented. 2,6,16,19 Several limitations with this study merit discussion. Notably, this study is limited by its retrospective nature with no control group inclusive of other surgical approaches and assesses only the outcomes of 2 surgeons.…”

Section: Discussionmentioning

confidence: 93%

“…This relationship between fracture severity and development of symptomatic posttraumatic arthritis is well-documented. 2,6,16,19…”

Section: Discussionmentioning

confidence: 99%

“…1–3 The sinus tarsi approach (STA) has emerged as a minimally invasive approach that attempts to minimize soft-tissue insult when compared with the ELA. 4–6 This approach has gained popularity with low reported frequencies of wound complications without compromise of articular reduction quality. 7,8…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The sinus tarsi approach (STA) has emerged as a minimally invasive approach that attempts to minimize soft-tissue insult when compared with the ELA. [4][5][6] This approach has gained popularity with low reported frequencies of wound complications without compromise of articular reduction quality. 7,8 At present, several studies, including randomized controlled trials, have emerged comparing clinical and functional outcomes between the STA and ELA.…”

Section: Introductionmentioning

confidence: 99%

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Surgeon Learning Curve for the Sinus Tarsi Approach to Intra-articular Calcaneus Fractures – Improvement with Experience

Joseph

McCaskey

Bhatt

et al. 2023

Journal of Orthopaedic Trauma

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Objective: To analyze the relationship between surgeon experience with the sinus tarsi approach (STA) and outcomes in the treatment of displaced intra-articular calcaneus fractures (DIACF). Setting: Single level 1 trauma center Design: Retrospective. Patients/Participants: 103 consecutive DIACF (OTA/AO 82C; Sanders II-IV) treated operatively using STA from 2015 to 2021. Intervention: Open management using the STA performed by two fellowship-trained orthopaedic traumatologists. Main Outcome Measurement: Quality of anatomic reduction based on postoperative CT scans and standard radiographs. Results: Sixty-six patients met inclusion criteria. Patients were primarily men (75.8%) with mean age 41 years (range 20-71 years), including 14 smokers (21.2%), 9 diabetics (13.6%), and 10 open fractures (15.2%). Sanders III fractures were most common (68.2% vs 28.5% and 6.1% Sanders II/IV respectively). Reduction quality was predominantly Good (59.1%, n=39) or Excellent (25.8%, n=17). Complications included wound necrosis (1), superficial infection (1), deep infection (1), and symptomatic posttraumatic arthritis requiring arthrodesis (3). There was a 29.3% reduction in likelihood of surgical complication with each year in surgeon experience with the STA and an 8.9% reduction per case (p<0.001). The likelihood of achieving a Good or Excellent reduction was 1.8 and 2.3 times greater than achieving a Fair reduction, respectively, for each year increase in surgeon experience with the STA (p=0.012 and 0.007, respectively). For each successive case, there was a 1.2 times greater likelihood of achieving a Good reduction (p=0.03). Conclusion: Surgeon experience plays a critical role in outcomes. We found that outcomes (reduction, complications) improve with each cumulative case and year of experience with the STA to treat DIACF. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 93%

“…This relationship between fracture severity and development of symptomatic posttraumatic arthritis is well-documented. 2,6,16,19…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgeon Learning Curve for the Sinus Tarsi Approach to Intra-articular Calcaneus Fractures – Improvement with Experience

Joseph

McCaskey

Bhatt

et al. 2023

Journal of Orthopaedic Trauma

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“…Lastly, surgery was carried out as soon as the skin condition became stable enough to suture with an average of 3.28 days from the fracture. However, it is not clear whether it contributed to a lower complication rate because correlation between timing of surgery from the fracture and wound complication remains unclear, especially in the sinus tarsi approach [35,36]. Regarding the sural nerve injuries, none occurred during the surgery, probably because the horizontal incision avoided the course of the sural nerve.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture

Cho

Kim

Kang

et al. 2021

IJERPH

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Although various outcomes of the sinus tarsi approach have been reported, these are limited to the Sanders type 2 displaced intraarticular calcaneal fractures (DIACF) because of the limited visibility of the posterior facet joint. In this study we aimed to (1) introduce a sinus tarsi approach combined with an anterolateral fragment open-door technique that enables adequate visibility of the innermost and middle portion of the posterior facet joint, and (2) evaluate the radiographic and clinical outcomes of the patients treated with that technique. This is a retrospective case-series study performed on medical records of 25 patients who presented with the Sanders type 3 or 4 DIACF and were treated with the sinus tarsi approach. The radiologic measurements showed significant corrections of the Bohler’s angle, calcaneal width, length, height, and articular step-off in both X-rays and CTs in the last follow-up period. The mean AOFAS score was 90.08 ± 6.44 at the last follow-up. Among all the follow-up patients, two cases (8%) had acute superficial infections, and no other wound complications occurred. Therefore, we suggest that the Sanders type 3 or 4 DIACF could be successfully treated with the proposed technique with low complications and bring out effective clinical and radiologic outcomes.

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Calcaneus Fractures

Rammelt

Marx

2022

Foot and Ankle Disorders

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Acute Fixation of Displaced Intra-articular Calcaneus Fractures Is Safe Using the Sinus Tarsi Approach

Abstract: To analyze the correlation between surgical timing and outcomes for calcaneus fractures treated using a sinus tarsi approach (STA).

Cited by 8 publications

References 35 publications

Surgeon Learning Curve for the Sinus Tarsi Approach to Intra-articular Calcaneus Fractures – Improvement with Experience

Surgeon Learning Curve for the Sinus Tarsi Approach to Intra-articular Calcaneus Fractures – Improvement with Experience

Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture

Calcaneus Fractures

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