Comparison Between Sinus Tarsi Approach and Extensile Lateral Approach for Treatment of Closed Displaced Intra-Articular Calcaneal Fractures: A Multicenter Prospective Study

Minimally invasive (sinus tarsi) approach for calcaneal fractures

“…Our results seemed to be superior to those of the study by Kikuchi et al [10], in which the sinus tarsi approach was also used: three of their cases (13.6%) had superficial wound infections, and no statistical differences were present in the Gissane angle, calcaneal height, and calcaneal length between preoperatively and postoperatively. Moreover, in the study of Basile et al, three patients (7.9%) who underwent the sinus tarsi approach failed to achieve anatomic reduction [5]. These findings indicated the effectiveness and safety of our plate for calcaneal fractures.…”

“…The use of open reduction through a minimally invasive sinus tarsi approach and stabilization with a locking plate is now a widely accepted treatment for calcaneal fractures [5–7, 15, 16]. However, all the currently used locking plates are in one piece, which requires a large working space for placement, leading to the necessity of sufficient exposure of the lateral wall of the calcaneus and even establishment of assisted incision [7].…”

“…This may increase the injuries to the soft tissues and the risk of wound complications. In addition, simultaneous fixation of multiple fracture blocks also induces difficulty in operation, easily causing poor anatomic reduction [5, 17]. To minimize the above problems, we newly designed and patented a combined plate in 2014.…”

“…Several randomized controlled trials have demonstrated a similar reduction; however, a significantly decreased risk of wound complications can be obtained with this procedure in comparison with the lateral extended approach [5, 6]. Nevertheless, the poor visualization of the lateral wall of the calcaneus through this small incision makes it difficult to insert the conventional plate for obtaining a stable fixation.…”

Fracturas de calcáneo: controversias y consensos

“…También Kwon et al 19 publican una mayor incidencia de complicaciones (hasta 32%) en pacientes tratados mediante abordaje lateral frente a un 5,3% en pacientes intervenidos mediante abordajes percutáneos o abordaje del seno del tarso. Recientemente, Basile et al 26 publican un interesante artículo basado en un estudio prospectivo y multicéntrico comparando el abordaje del seno del tarso vs abordaje lateral estándar en 2 grupos comparables de pacientes. Concluyen los autores que si bien los resultados funcionales son similares en ambos grupos, el abordaje del seno del tarso presentaba menor incidencia de complicaciones de la herida quirúr-gica, menor tiempo quirúrgico y un menor tiempo de demora para la cirugía definitiva que el abordaje clásico lateral.…”