Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures

Sato, Kei; Yorimitsu, Masanori; Uehara, Tomoko; Fukuoka, Shiro; Hata, Toshiaki; Saiga, Kenta; Noda, Tomoyuki; Ozaki, Toshifumi

doi:10.1016/j.fas.2022.11.002

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…Unlike the results of our analysis, Pitts et al, 12 who compared SF with nonspecified PF, found no significant differences in BA postoperatively, decrease in BA after approximately 1 year, and SSI between SF and PF/APF. On the other hand, Guo et al 5 and Sato et al 16 described results comparable to our study, despite a significantly higher implant removal rate for APF as compared to SF in the study of Guo et al 5 One of the possible explanations for the higher implant removal rate could be the longer follow-up (mean 44.2 months) for the APF group as compared to our study (median 29.8 months). In addition to this, Chotikkakamthorn et al 3 showed that SF, in comparison to APF, provided inferior stability of the posterior facet fixation and calcaneal varus reduction with a lower complication rate.…”

Section: Discussionsupporting

confidence: 70%

“…11,21,22 Utilizing STA, different fixation methods can be used such as screw fixation (SF), plate fixation (PF), and more recently anatomic plate fixation (APF) specifically designed for the calcaneus and indicated for the sinus tarsi approach. Although there is literature available comparing the outcome of both SF and PF or APF, 3,5,7,12,16 there is a paucity comparing the surgical outcome of SF, PF, and APF while combining this with functional and quality of life patientreported outcomes. Therefore, the aim of this study is to compare both the surgical, functional, and quality of life outcome of SF, PF, and APF via STA for DIACFs.…”

Section: Introductionmentioning

confidence: 99%

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Implant Choice and Outcomes of the Sinus Tarsi Approach for Displaced Intra-articular Calcaneal Fractures

Eelsing,

Aronius,

Halm

et al. 2023

Foot Ankle Int.

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Background: Operative fixation of displaced intra-articular calcaneal fractures is considered the gold standard, for which multiple fixation methods are available. This study compares the (functional) outcome of screw fixation (SF), plate fixation (PF), and anatomical plate fixation (APF) via the sinus tarsi approach (STA). Methods: A total of 239 patients (265 fractured calcanei) who received surgical treatment of a displaced intra-articular calcaneal fracture via STA between 2011 and 2022 were included. Results: Böhler angle (BA) measured immediately postoperatively (BA post-OR) and the decrease in BA at 1 year (∆BA) differed significantly in favor of PF/APF compared with SF (BA post-OR: SF vs PF P = .010 and SF vs APF P = .001; ∆BA: SF vs PF P = .032 and SF vs APF P = .042). Implant removal surgery was performed significantly less in the APF group as compared to the SF/PF groups (APF vs SF/PF; 9.9% vs 22.9%/23.7%, P = .015). Surgical site infections and secondary arthrodesis of the subtalar joint occurred equally in the 3 groups. Furthermore, the mean American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, Foot Function Index score, and EuroQOL-5D-index / visual analog scale score, did not differ notably between SF, PF, and APF. Conclusion: The results show that both PF and APF are favored over SF because of an improved correction of BA measured directly postoperatively, a lower secondary loss of BA and, for APF, a lower implant removal rate. There was no difference in the rate of surgical site infections, need for secondary arthrodesis, nor functional outcome scores between different implants using the STA. Level of Evidence: Level III, retrospective cohort study.

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