Comparison of sinus tarsi and lateral L-shaped approaches in medial wall reduction and calcaneal alignment in treatment of calcaneal fractures / 中华创伤骨科杂志

ABSTRACT

Objective To compare the minimally invasive sinus tarsi approach and lateral intensive L-shaped approach in the therapeutic effects concerning medial wall reduction and calcaneal alignment for cal-caneal fractures. Methods A retrospective analysis was conducted of the 52 patients with calcaneal fracture who had been treated at Department of Foot & Ankle Surgery, Guangzhou Orthopaedic Hospital from January 2010 to December 2014. They were 39 men and 13 women, 28 to 46 years of age ( average, 40.4 years ). Of them, 26 were treated via the sinus tarsi approach ( minimally invasive group ) and the other 26 via the con-ventional lateral extensile L-shaped approach ( conventional group ) . X-ray axial films of the calcaneus were taken pre-operatively and post-operatively to evaluate the medial wall reduction and calcaneal alignment. The American Orthopedic Foot Ankle Society ( AOFAS ) ankle-hindfoot scale was adopted to assess the therapeutic effects. Results The average follow-up period for this cohort was 18 months ( from 12 to 24 months). The post-operative varus angle was 7.41°± 5.17°for the minimally invasive group and 8.01°± 5.33°for the con-ventional group; the correction of varus angle was 6.60°± 6.23°for the minimally invasive group and 8.57°± 6.64°for the conventional group; the good to excellent rate of medial wall reduction was 42.3% ( 11/26 ) for the minimally invasive group and 53.8% ( 14/26 ) for the conventional group; the AOFAS score was 89.5 ± 7.0 for the minimally invasive group and 86.2 ± 8.2 for the conventional group. There were no statistically signifi-cant differences between the 2 groups in all the above comparisons ( P ＞ 0.05 ). Conclusion The mini-mally invasive sinus tarsi approach can be a fine choice for treatment of calcaneal fractures, because it leads to no differences in medial wall reduction, postoperative varus angle and postoperative correction of varus angle, compared with the conventional lateral extensile L-shaped approach.