A Comparative Study of Displaced Intra-Articular Fractures of Calcaneum Treated by Extensile Lateral Versus Sinus Tarsi Approach

Description

Abstract (English)

Introduction: Currently, Open Reduction Internal Fixation (ORIF) through the Extensile
Lateral approach is considered the most widely accepted surgical procedure for displaced
intra- articular calcaneal fracture. Minimally invasive reduction and fixation techniques via
Sinus Tarsi approach (STA) have been developed in attempts to avoid potential
complications associated with an extensile lateral approach, The purpose of this study is to
evaluate functional and clinical outcome of displaced intra- articular fractures of calcaneum
(DIACF) treated by using Extensile Lateral and Sinus Tarsi approaches.
Materials and Methods: This study was carried out in GMERS Medical College and
General Hospital Gotri Vadodara from August 2020 to May 2022, consisting of total 42
patients of intra-articular fractures of calcaneum. This was a comparative prospective study.
All the patients were operated by surgeons experienced in both the approaches.
Results: Majority were male patients with mean age of 37 years and had history of fall from
height as mode of injury and had unilateral calcaneum fracture. 90.5% of patients for ST
approach were operated within 4 days of admission as compared to 61.9% of patients for EL
approach who were operated within 4-6 days of admission. Days of hospitalization were
more for EL compared to ST group with significant difference (P<0.005) Functional
outcome at 24 weeks by AOFAS scoring system depends on fracture pattern and approach
used for it. AOFAS score 78/100 for ST approach for Sanders type 2 and 75/100 for EL
approach for Sanders type 3. EL group had more complications in the form of plate removal
due to infection, skin necrosis or wound dehiscence as compared to ST group.
Conclusion: Our study showed better results for Sander's Type II Calcaneal fractures by
Sinus Tarsi approach and better results for Sander's Type III Calcaneal fractures by
Extensile Lateral approach.