José Machado (Matosinhos / PT), João Campos (Matosinhos / PT), Andreia Moreira (Matosinhos / PT), João Quelhas (Matosinhos / PT), Pedro Santos (Matosinhos / PT), Patrícia Martins (Matosinhos / PT), Luís Carvalho (Matosinhos / PT)
Abstract text (incl. references and figure legends)
Open reduction and internal fixation of displaced intraarticular calcaneal fractures remain the gold standard of treatment, but the traditional extensile approach has been associated with relatively frequent complications.
The current study aims to evaluate a less invasive sinus tarsi approach and to elaborate on the associated complications, risk factors, function and outcome predictors. A retrospective analysis of patients with calcaneal fractures admitted to our Department of Traumatology and Orthopaedics from 2012 to 2022 and treated surgically with a percutaneous plate using a sinus tarsi aproach was performed. Patients with a follow up of less than 9 months were excluded.
A total of 55 calcaneal fractures in 54 Patients (38 males and 16 females) with a average age of 52 years old and a mean follow up of 34 months were assessed regarding the complications, pre and postoperative Bohler's and Gissane"s angles, calcaneal length and ankle-hindfoot function evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) score at the last follow-up. Type IV calcaneal fracture, according to Sander's classification, showed significantly more complications than other types (p < 0.001). There were significant correction (p < 0.001) of Bohler's angle (preoperative and postoperative average 11.7 and 27.8) as well as Gissane's angle (preoperative and postoperative average 134.8 and 122.3). Was archieved lenght correction (less than 1mm of difference to contralateral) in 92% of patients. The mean AOFAS score was 82.9. One patient (1.8%) had a deep infection at 2 months with the need for material extraction and 2 (3.6%) had delayed healing of the skin but closed the surgical wound before 30 days. During follow-up, 3 (5.5%) patients underwent subtalar arthrodesis.
In the treatment of calcaneal fractures, a minimally invasive sinus tarsi approach can achieve satisfactory reduction, good funcional outcomes with few postoperative complications.
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