Retrospective analysis of two minimally invasive approaches for displaced intra-articular calcaneal fractures:minimal invasive longitudinal approach and sinus tarsi approach / 中华骨科杂志

ABSTRACT

Objective To investigate the clinical results of two minimally invasive approaches for calcaneal fractures.Methods The data of 93 patients with displaced intra-articular calcaneal fractures was retrospectively analyzed who were treated from April 2010 to September 2010 in our trauma centre.The patients were divided into two groups according to different minimally invasive approaches.Group A consisted of 50 patients (51 feet) who were treated with the minimally invasive longitudinal approach,including 47 males and 3 females with an average age of 38.22 years.Type Sanders II included 27 feet,type Ⅲ included 18 feet and type Ⅳ included 6 feet.B(o)hler angle was-1.1° on average before operation.Group B consisted of 43 patients (45 feet) who were treated with the sinus tarsi approach,including 42 males and 1 female with an average age of 41.40 years.Type Sanders II included 23 feet,type Ⅲ included 17 feet and type Ⅳ included 5 feet.B(o)hler angle was 2.6° on average before operation.The difference was investigated between the two groups in their operation time,complications and the scores according to the ankle and hindfoot score system of American Orthopaedic Foot and Ankle Society (AOFAS).Results All patients were followed up in the two groups.The average time of follow-up was 28.2 months in Group A and 27.6 months in Group B.The mean operation time was 40.78 mins in Group A and 60.67 mins in Group B.The rate of complications in Group A was 3.92％ (2/51),and 8.89％ (4/45) in Group B.The mean AOFAS score was 85.96 in Group A and 88.60 in Group B.Conclusion No statistically significant difference was found between the mininally invasive longitudinal approach and the sinus tarsi approach in the effect of the treatment for the displaced intra-articular calcaneal fractures.However,the minimally invasive longitudinal approach could be a better choice for its shorter operation time and lower rate of complications than the sinus tarsi approach.