Title : Short-to-medium term functional and radiological outcomes of intra-articular calcaneum fracture fixation using sinus tarsi approach
Abstract:
Introduction: The extensile lateral approach for calcaneum fracture fixation has high complication rates of 25-30%. Sinus tarsi approach is a minimally invasive surgical technique for fixing calcaneal fractures with minimal wound complications.
Aim: To assess the short-to-medium term functional and radiological outcomes and complication rates of intra-articular calcaneum fracture fixation using sinus tarsi approach.
Methodology: Retrospective study of 27 patients with intra-articular displaced calcaneum fractures fixed using sinus tarsi approach from 2015-2022. All patients had pre-operative radiographs, CT scans and appropriate DVT prophylaxis. Sanders classification and pre- and post-operative Bohler angle measurements were used. Functional outcome was measured using Manchester Oxford Foot Questionnaire (MOxFQ) scores and complications rates, including subtalar fusion rates, were assessed.
Results: Our study had a male to female ratio of 4:1 with a mean age of 48 years (22-79) with 1 to 8 years follow-up. Ten patients were active smokers. The mean pre-operative Bohler angle was 9.41+/-8.2 and achieved post-operative Bohler angle was 27.5+/-5 with an improvement in the Bohler's angle of 18+/-3.5, which is statistically significant (P value < 0.0001). The mean MOxFQ score was 55.93 (27.8-78.3). One patient developed wound infection requiring implant removal. 8 patients had radiological evidence of arthritis but none required fusion. All but five patients were able to return to their pre-injury occupation.
Conclusion: In our study, patients had fair to good functional outcomes with good radiological outcomes and less revision rates. Minimally invasive calcaneal fracture fixations using sinus tarsi approach significantly restores Bohler angle with minimal complication rates.
