Sinus Tarsi Versus Extended Lateral Approach for Displaced Intra-Articular Calcaneal Fractures: A Single Surgeon's Experience

Authors

• Philip K Lim
• Adam J Miller
• Justin Haghverdian
• Ramzy Meremikwu
• M Kareem Shaath
• John W Munz

Language

English

Publication Date

8-1-2025

Journal

Foot & Ankle Specialist

DOI

10.1177/19386400231152096

PMID

37013256

PMCID

PMC12228890

PubMedCentral® Posted Date

4-3-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background

The aim of the study is to investigate the differences between the extensile lateral (EL) and sinus tarsi (ST) approaches for the treatment of displaced intra-articular calcaneus fractures as treated by a single surgeon.

Methods

A retrospective cohort study performed at a Level 1 trauma center. One hundred twenty-nine consecutive intra-articular calcaneus fractures from 2011 to 2018 that were surgically treated by a single surgeon. Primary outcomes were time to surgery, operative time, postoperative restoration of the critical angle of Gissane, postoperative wound complications, and need for unplanned re-operation.

Results

Patient characteristics, including demographics, mechanism of injury, and fracture patterns were similar between the EL and ST approach groups. There was a significant decrease in unplanned secondary procedures (P = .008), shorter time to definitive fixation (P = .00001), and shorter average operative time in the ST group (P = .00001). Postoperative measurement of the critical angle of Gissane between the two groups was significantly different, but minute with an average difference of approximately 3 degrees (P = .025). Measurements in both groups were within the expected range of normal.

Conclusions

For displaced intra-articular calcaneus fractures, a limited open ST approach is associated with a significant reduction in the time to definitive fixation and decreased operative time. The EL approach was associated with a small, but significant improvement in the restoration of the critical angle of Gissane compared with the ST approach. Therefore, an ST approach may allow for earlier surgical intervention and result in equivalent quality of reduction compared with an EL approach.

Level of Evidence:

Level III

Keywords

Humans, Calcaneus, Retrospective Studies, Male, Intra-Articular Fractures, Female, Fracture Fixation, Internal, Middle Aged, Adult, Operative Time, Fractures, Bone, Treatment Outcome, calcaneus fracture, extensile lateral, sinus tarsi

Published Open-Access

yes

Recommended Citation

Lim, Philip K; Miller, Adam J; Haghverdian, Justin; et al., "Sinus Tarsi Versus Extended Lateral Approach for Displaced Intra-Articular Calcaneal Fractures: A Single Surgeon's Experience" (2025). Faculty, Staff and Student Publications. 3994.
https://digitalcommons.library.tmc.edu/uthmed_docs/3994