Functional outcome of the sinus tarsi approach in the treatment of intraarticular calcaneal fractures
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252637Keywords:
Intraarticular, Bohler’s angle, Gissane, Angle subtalar joint involvement, Heel wideningAbstract
Background: Intraarticular calcaneal fracture is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in thirty patients, all of which were managed by sinus tarsi approach an average follow-up period of 18 months. Though open reduction is prevailing, this technique also gives favorable outcome.
Methods: Thirty patients with intraarticular calcaneal fracture were managed by dorsal tarsi approach using between March 2023 to November 2025 were included in this series. All cases were treated with closed reduction. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted.
Results: Of the Thirty patients in the study, twenty-two were males and eight were females. The mean age was 40.4 years (range 18 to 65 years). Eighteen out of thirty patients (60%) had the dominant side fractured). The mean fracture union (radiological) time was 8 weeks (range: 6-12 weeks) and clinical union time was 8.5 weeks week. However, ankle function was excellent in 30 cases (100%).
Conclusions: This study confirmed a high overall rate of union and excellent functional outcomes sinus tarsi approach for a intraarticular calcaneal fractures give good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time-consuming method intraarticular calcaneal fracture. When the surgeon is experienced in the technique.
Metrics
References
Slätis P, Kiviluoto O, Santavirta S, Laasonen EM. Fractures of the calcaneal. J Trauma. 1979;19(12):939-43. DOI: https://doi.org/10.1097/00005373-197912000-00001
Zwipp H, Rammelt S, Barthel S. calcaneal fractures--open reduction and internal fixation (ORIF). Injury. 2004;35:SB46-54. DOI: https://doi.org/10.1016/j.injury.2004.07.011
Rowe CR, Sakellarides HT, Freeman PA, Sorbie C. Fractures of the os calcis: a long-term follow-up study of 146 patients. JAMA. 1963;184(12):920-3. DOI: https://doi.org/10.1001/jama.1963.03700250056007
Lindsay WR, Dewar FP. Fractures of the os calcis. Am J Surg. 1958;95(4):555-76. DOI: https://doi.org/10.1016/0002-9610(58)90438-0
Rammelt S, Barthel S, Biewener A, Gavlik JM, Zwipp H. Calcaneus fractures. Open reduction and internal fixation. Zentralblatt Fur Chirurgie. 2003;128(6):517-28.
Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95.
Heckman JD. Fractures and dislocations of the foot‖, chapter 32, in Rockwood and Green's Fractures in adults. Vol. 2, 4th Edition, Philadelphia: Lippincott-Raven Publishers. 1996;30.
Mc Reynolds IS. Trauma to the Os Calcis and heel Cord‖, chapter 55, in Jahss Disorders of the foot, Vol. 2, Philadelphia: W.B. Saunders Company. 1982;21.
Sanders R. Displaced intra-articular fractures of the calcaneus: Current concepts review. J Bone Joint Surg. 2000;82(2):225-50. DOI: https://doi.org/10.2106/00004623-200002000-00009
Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95. DOI: https://doi.org/10.1097/00003086-199305000-00012
Parkes JC II. The Nonreductive Treatment of Fractures of the Os Calcis. Orthop Clin North Am. 1973;4(1):193-5. DOI: https://doi.org/10.1016/S0030-5898(20)30516-2
Salama R, Benamara A, Weissman SL. Functional Treatment of Intraarticular Fractures of the Calcaneus. Clin Orthop. 1976;(115):236-40. DOI: https://doi.org/10.1097/00003086-197603000-00041
Omoto H, Sakurada K, Sugi M, Nakamura K. A New Method of Manual Reduction for Intraarticular Fracture of the Calcaneus. Clin Orthop. 1982;(177):104-11. DOI: https://doi.org/10.1097/00003086-198307000-00015
Miller WE. Pain and Impairment Considerations Following Treatment of Disruptive Os Calcis Fractures. Clin Orthop. 1983;(177):82-6. DOI: https://doi.org/10.1097/00003086-198307000-00013
Benirschke SK, Sangeorzan BJ. Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures. Clin Orthop. 1993;(292):128-34.
Pozo JL, Kirwan EO, Jackson AM. The Long-Term Results of Conservative Management of Severely Displaced Fractures of the Calcaneus. J Bone Joint Surg. 1984;66(3):386-90. DOI: https://doi.org/10.1302/0301-620X.66B3.6725350
Harding D, Waddell JP. Open Reduction in Depressed Fractures of the Os Calcis. Clin Orthop. 1985;(199):124-31. DOI: https://doi.org/10.1097/00003086-198510000-00017
Romash MM. Reconstructive osteotomy of the Calcaneus with Subtalar Arthrodesis for Malunited calcaneal Fractures. Clin Orthop. 1993;(290):157-67. DOI: https://doi.org/10.1097/00003086-199305000-00020
Crosby LA, Fitzgibbons T. Computerized Tomography Scanning of Acute Intra-Articular Fractures of the Calcaneus. J Bone Joint Surg. 1990;72(6):852-9. DOI: https://doi.org/10.2106/00004623-199072060-00009
Buckley RE, Meek RN. Comparison of Open versus Closed Reduction of Intra-articular calcaneal Fractures: A Matched Cohort in Workmen. J Orthop Trauma. 1992;6(2):216-22.
Leung KS, Yuen KM, Chan WS. Operative Treatment of Displaced Intra-Articular Fractures of the calcaneal. J Bone Joint Surg. 1992;75(2):196-201. DOI: https://doi.org/10.1302/0301-620X.75B2.8444936
Bezes H, Massart P, Delvaux D, Fourquet JP, Tazi F. The Operative Treatment of Intraarticular calcaneal Fractures: Indications, Technique, and Results in 257 Cases. Clin Orthop. 1993;(290):55-9. DOI: https://doi.org/10.1097/00003086-199305000-00008
Parmar HV, Triffitt PD, Gregg PJ. Intra-articular fractures of the calcaneal treat- ed operatively or conservatively: a prospective study. J Bone Joint Surg [Br]. 1993;75:932-7. DOI: https://doi.org/10.1302/0301-620X.75B6.8245085
Richard B, Suzanne T, Robert McC, Graham P, Ross L, Dave P, et al. Operative Compared with Nonoperative Treatment of Displaced Intra-Articular Calcaneal Fractures: A Prospective, Randomized, Controlled Multicenter Trial; J Bone Joint Surg Am. 2002;84(10):1733-44. DOI: https://doi.org/10.2106/00004623-200210000-00001
Zeman P, Zeman J, Matejka J, Koudela K. Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach. Acta Chir Orthop Traumatol Cech. 2008;75(6):457-64. DOI: https://doi.org/10.55095/achot2008/085
Jarvholm U, Korner L, Thoren O, Wiklund LM. Fractures of the calcaneus. Acomparison of open and closed treatment. Acta Orthop Scand. 1984;55(6):652-6. DOI: https://doi.org/10.3109/17453678408992416
Buckley RE, Meek RN. Comparison of open versus closed reduction of Intraarticular calcaneal fractures: a matched cohort in workmen. J Orthop Trauma. 1992;6(2):216-22. DOI: https://doi.org/10.1097/00005131-199206000-00014
Kundel K, Funk E, Brutscher M, Bickel R. calcaneal fractures: operative versus nonoperative treatment. J Trauma. 1996;41:839-45. DOI: https://doi.org/10.1097/00005373-199611000-00012
Mc Reynolds IS. The case for operative treatment of fractures of the os calcis. In Leach RE, Hoaglund FT, Riseborough EJ, eds. Controversies in orthopedic surgery. Philadelphia. WB Sanders. 1982;232-54.
Palmer I. The mechanism and treatment of fractures of the calcaneus. J Bone Joint Surg Am. 1948;30:2-8. DOI: https://doi.org/10.2106/00004623-194830010-00002
Schepers T, Van Lieshout EM, GInai AZ, Mulder PG, Heetveld MJ, Patka P. calcaneal fracture classification: a comparative study. J Foot Ankle Surgery. 2009;48(2):156-62. DOI: https://doi.org/10.1053/j.jfas.2008.11.006
Humphery CA, Dirschl DR, Ellis TI. Interobserver reliability of a CT based fracture classification system. J Orthop Trauma. 2005;19(9):616-22. DOI: https://doi.org/10.1097/01.bot.0000177107.30837.61
O'Farrell DA, O'Byrne JM, McCabe JP, et al. Fractures of the os calcis: im- proved results with internal fixation. Injury. 1993;24(4):263-265. DOI: https://doi.org/10.1016/0020-1383(93)90183-7
Ibrahim T, Rowsell M, Rennie W, Brown AR, Taylor GJS, Gregg PJ. Displaced intra-articular calcaneal fractures: 15 year follow up of a randomized controlled trail of conservative versus operative treatment. Injury. 2007;38(7):848-55. DOI: https://doi.org/10.1016/j.injury.2007.01.003
Benirschke SK, Sangeorzan BJ. Extensive intra-articular fractures of the foot. Surgical management of calcaneal fractures. Clin Orthop. 1993;(292)128-34. DOI: https://doi.org/10.1097/00003086-199307000-00015
Stephaenson JR. Treatment of displaced intra-articular fractures of the calcaneus using medial and lateral approaches, internal fixation, and early motion. J bone Joint Surg Am. 1987;69(1):115-30. DOI: https://doi.org/10.2106/00004623-198769010-00019
Muller ME, Allgower M, Schneider R. annual of Internal fixation. Techniques recommended by AO group. 2nd edition. New York: Springer. 1979;71-87.
Barei DP, Bellabarba C, Sangeorzan BJ, Benirschke SK. Fracture of the Calcaneus. OCNA. 2002;33(1):263-85. DOI: https://doi.org/10.1016/S0030-5898(03)00084-1
LeTournel E. Open reduction and internal fixation of calcaneal fractures. In Spiegel P, ed. Topics in Orthopedic Surgery. Baltimore, MD: Aspen Publishers. 1984;173-92.
Burdeaux BD Jr. The medical approach for calcaneal fractures. Clin Orthop Relat Res. 1993;(290):96-107. DOI: https://doi.org/10.1097/00003086-199305000-00013
Low CK, Mesenas S, Lam KS. Results of closed intra articular calcaneal fractures treated with early mobilization and without reduction. Ann Acad Med Singapore. 1995;24:820-22.
Di Schino M, Bensaida M, Vandenbussche E, Augereau B, Nich C. Results of open reduction and cortico cancellous autograft of intra-articular calcaneal fractures according to Palmer. Rev Chir Orthop Reparatrice Appar Mot. 2008;94(2):135-44. DOI: https://doi.org/10.1016/j.rco.2007.04.007
Buckley R. Letters to the editor. J Orthop Trauma. 2002;16:210-1. DOI: https://doi.org/10.1097/00005131-200203000-00015
Hart AJ, Eastwood DM. Displaced intra-articular fractures of the calcaneus: What is new? Trauma. 2003;5(1):9-21. DOI: https://doi.org/10.1191/1460408603ta259oa