Outcomes of Minimally-Invasive Sinus Tarsi Approach for the Treatment of Intra-articular Calcaneal Fracture

Background: Open reduction and internal fixation is the standard surgical treatment of calcaneal fractures. However, it is associated with a high rate of wound problems. Objectives: In this study, we evaluated the clinical and radiologic outcomes, as well as the wound complication rates of sinus tarsi minimally-invasive approach in the treatment of intraarticular calcaneus fracture. Methods: In a retrospective study, 62 patients who were referred with an intra-articular calcaneus fracture and treated with a minimally-invasive sinus tarsi approach were included. The radiographic evaluations included the assessment of Bohler and Gissane angles before and after the surgery, as well as the height and length of the calcaneus. The clinical outcome was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire. Results: The Mean±SD age of the patients was 41.8±12.7 years. The Mean±SD follow-up of the patients was 21.3±10 months. After 6 months, in 43 patients (69.3%) both Bohler’s and Gissane’s angles were significantly improved after the surgery (P=0.003 and P 0.001, respectively). The calcaneus height was significantly improved after the surgery (P=0.009), as well. The Mean±SD AOFAS score of the patients was found 79.6±7. Wound infection was seen in only 1 case (1.6%). Delayed wound healing occurred in 4 cases (6.4%). No other wound complication such as dehiscence and skin necrosis was recorded. Conclusion: Minimally-invasive sinus tarsi approach is an efficacious procedure for the treatment of intra-articular calcaneus fracture with a minimized rate of wound complications.