SLR - July 2012 - T. J. Martin
Reference: Schepers T. The sinus tarsi approach in displaced intra-articular calcaneal fractures: A systematic review. International Orthopaedics. 2011 Feb: 35:697-703
Scientific Literature Review
Reviewed by: T. J. Martin, DPM
Residency Program: North Colorado Medical Center
Podiatric Relevance:
Although open reduction and internal fixation is considered the gold standard for displaced intra-articular calcaneal fractures, various limited lateral approaches exist. This systematic review shows results of the sinus tarsi approach, which is the most frequently used limited lateral approach.
Methods:
This review presents eight case series from several medical centers reporting on 256 patients with 271 calcaneal fractures. Information was obtained from the electronic databases of the Cochane Library and Pubmed Medline while searching for the sinus tarsi approach utilized for the treatment of displaced intra-articular calcaneal fractures.
Results:
Of the 271 calcaneal fractures followed in 256 patients with an average follow-up time of 32.9 months, an overall good to excellent outcome was reached in over 75 percent of all patients when using the AOFAS score. An average complication rate of minor wound complications was 4.1 percent and the major wound complication average was 0.7 percent. The need for secondary subtalar arthrodesis occurred at an average of 4.3 percent.
Conclusions:
The functional outcome and complication rates of the sinus tarsi approach for displaced intra-articular calcaneal fractures compare similarly to the extended lateral approach when comparing need for secondary arthrodesis, and compare favorably to superficial and deep wound complications and sural nerve injuries. Therefore, the sinus tarsi approach should be considered effective when tailoring the best treatment modality for the right patient and the right fracture type.