A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture

Jeong-Seok Moon; Woo-Chun Lee

doi:10.12671/jkfs.2009.22.1.13

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Moon and Lee: A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture

Original Article

Journal of the Korean Fracture Society 2009; 22(1): 13-18.

Published online: 31 January 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.1.13

A Comparison of Extensile Lateral Approach and Sinus Tarsi Approach for the Sanders Type II Calcaneal Fracture

Jeong-Seok Moon, M.D., Woo-Chun Lee, M.D.

Department of Orthopedic Surgery, Seoul Paik Hospical, College of Medicine, Inje University, Seoul, Korea.

Address reprint requests to: Jeong-Seok Moon, M.D. Department of Orthopedic Surgery, Seoul Paik Hospical, College of Medicine, Inje University, 85, Jeo-dong 2-ga, Jung-gu, Seoul 100-032, Korea. Tel: 82-2-2270-0028, Fax: 82-2-2270-0023, moonbak502@hanmail.net

Received 30 September 2008 Accepted 20 November 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the clinical results between the extensile lateral approach and sinus tarsi approach in the open reduction of the Sanders type II calcaneal fracture.

Materials and Methods

From July 2002 to Februry 2007, thirty two patients having thirty three calcaneal fractures of Sanders type II were managed with open reduction and internal fixation using the extensile lateral approach or sinus tarsi approach. The mean age of 19 patients using extensile lateral approach was 43.3 years. The mean age of 13 patients using sinus tarsi approach was 46.3 years. Clinical outcome, radiographic parameters, and postoperative complications were compared between both groups.

Results

There was no difference between two groups associated with patients demographs. The mean AOFAS score and VAS between both groups were not different (p=0.716, p=0.774). The mean Bohler's angle and Gissane's angle between both groups were not different (p=0.343, p=0.357). Two cases of sural nerve injury, one malunion, and one deep infection were occurred in the group of extensile lateral approach. However, patients using sinus tarsi approach had no postoperative complications.

Conclusion

The clinical results of sinus tarsi approach may be comparable with those of extensile lateral approach, with the advantages of reduced risk of postoperative complications.

Keywords: Calcaneus, Fracture, Extensile lateral approach, Sinus tarsi approach

Figures and Tables

Fig. 1

(A) Extensile lateral approach demonstrates exellent exposure of the subtalar joint and posterior tuberosity through the wide subperiosteal dissection.

(B) Sinus tarsi approach through the small incision over the sinus tarsi can not see the posterior tuberosity.

Fig. 2

(A) Lateral radiograph of the calcaneus shows measurements of the Bohler angle and the critical angle of Gissane.

(B) Broden's radiograph of the calcaneus shows measurement of the displacement between fracture fragments.

Table 1

Patients demographs with comparison between two groups who underwent surgery using the extensile lateral approach or the sinus tarsi approach

^*chi-square test, ^†Mann-Whitney U-test, ^‡student t-test.

Table 2

Comparison of the radiographic and clinical results between two groups after surgical treatment through the extensile lateral approach or through the sinus tarsi approach

^*Mann-Whitney U-test, ^†student t-test.

Table 3

Complications after surgical treatment through the extensile lateral approach or through the sinus tarsi approach

^*chi-square test, N.A: not assessable.

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