CME OnDemand: 2022 AOFAS Annual Meeting-Calcaneus Fracture Fixation: Assessing the Adequacy of the Sinus Tarsi Surgical Fixation Technique

Calcaneus Fracture Fixation: Assessing the Adequacy of the Sinus Tarsi Surgical Fixation Technique

Pdf Summary

The study aimed to assess the effectiveness and complications associated with the sinus tarsi approach (ST-a) for the management of calcaneus fractures, compared to the traditional lateral extensile incision. The study included 30 calcaneus fractures that were fixated through the ST-a by two specialized surgeons. Primary outcomes measured were radiographic measures, such as Bohler's angle on x-ray, and the maximum summative step deformity at the subtalar joint on CT scans. Secondary outcomes included soft tissue complications and the need for re-operation.<br /><br />The results showed that radiographically, the ST-a technique was successful in achieving acceptable joint reduction compared to industry standards. Bohler's angle was restored and the joint step deformities were corrected to anatomic levels. The incidence of soft tissue complications was lower than previously reported for the lateral extensile approach.<br /><br />The study concluded that the ST-a is a valuable method for the treatment of intra-articular calcaneus fractures, as it provides adequate joint reduction and reduces the risk of soft tissue complications. However, it should be noted that patient expectations should be managed, as even a well-reduced fracture on x-ray may still have imperfections seen on CT scans, which can lead to long-term complications.<br /><br />Overall, the study supports the use of the ST-a technique for calcaneus fracture management and suggests considering it as a viable option for operative treatment.

Asset Subtitle

Nebojsa Kuljic, Lee A. Kolla, MD, FRCS(C), Trent Thiessen, Scott Willms

Keywords

sinus tarsi approach

ST-a

calcaneus fractures

lateral extensile incision

radiographic measures

Bohler's angle

subtalar joint

CT scans

soft tissue complications

re-operation