SINUS TARSI APPROACH FOR TREATMENT OF DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES
The optimal treatment for displaced calcaneal fractures involving the posterior facet is surgical. Several minimally invasive techniques have been developed in recent years. Aim: We evaluated the results of calcaneal posterior facet reduction by a limited sinus tarsi approach combined with percutaneous reduction and screw fixation. Material and methods: Twenty-three consecutive patients (mean age 41 years) with 27 intra-articular calcaneal fractures were treated. After reduction and fixation of the posterior calcaneal facet, the final fixation of the calcaneal fractures was performed percutaneously with two or three 6.5 mm, fully threaded cancellous screws. Patient follow-up was on average 1.4 years. Results: Superficial wound edge necrosis was observed in one case (0.27%) which has healed within one week with local wound care. The Bohler angle has improved from an average of -0.89o preoperatively to 26.41o postoperatively. Median AOFAS score was 89 points and median MES score was 87 points at the final follow-up. Conclusions: Minimally invasive open reduction and percutaneous screw fixation of selected displaced intra-articular calcaneal fractures can achieve good to excellent functional and radiological outcomes. Sinus tarsi approach appears to be an effective and reliable method for the treatment of these fractures being associated with fewer wound complications and a shorter waiting time before surgery.
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