title: Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach.
abstract: BACKGROUND
  Two common surgical approaches included the sinus tarsi and extensile lateral are used for displaced intra-articular calcaneal fractures. However, few studies have compared outcome of treated by the two approaches. The purpose of this study was to compare the outcome between these two approaches for Sanders type-II and type-III fractures.
  
  
  METHODS
  This retrospective cohort study was performed from 2004 to 2011. Open reduction and internal fixation using the sinus tarsi and extensile lateral approach was studied in 100 cases (40 sinus tarsi and 60 extensile lateral) with displaced intra-articular calcaneal fractures. All patients were evaluated both clinically and radiologically.
  
  
  RESULTS
  Median Böhler and Gissane angle were improved to 26.5 degree (4.6 to 45), 115.5 degree (101.2 to 127.4) in the sinus tarsi group and 25.3 degree (3.7 to 44.6), 119.0 degree (73.5 to 145.6) in extensile lateral group at the final follow-up, respectively. Median calcaneal height, length, and width in the sinus tarsi and extensile lateral groups showed improvement to 45.1 mm (23.2 to 54.1), 75.9 mm (64.9 to 90.3), 37.6 mm (29.2 to 53.9) and 46.5 mm (32.7 to 59.5), 76.1 mm (67.3 to 97.9), 39.3 mm (29.2 to 47.8) at the final follow-up, respectively. Median AOFAS score was checked to 90 points (76 to 94) in the sinus tarsi group and 86 points (76 to 94) in the extensile lateral group at the final follow-up. No significant differences in clinical and radiologic outcomes were observed between the two groups. However, wound complication rate (13.3%) in the extensile lateral group was significantly higher compared to the sinus tarsi group (p-value = 0.022).
  
  
  CONCLUSIONS
  The final clinical and radiographic outcomes between the two approaches for Sanders type-II and type-III intra-articular calcaneal fractures were comparable and equally successful. The selective sinus tarsi approach appears to be an effective and reliable method for the treatment of Sanders type-II and type-III fractures.
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, 42 Jebongro, Donggu, Gwangju, 501-757, Republic of Korea. osdryeo@gmail.com.
authors.forename: Je-Hyoung
authors.initials: JH
authors.lastname: Yeo
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, 42 Jebongro, Donggu, Gwangju, 501-757, Republic of Korea. hjchoos78@gmail.com.
authors.forename: Hyun-Jong
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, 42 Jebongro, Donggu, Gwangju, 501-757, Republic of Korea. kbleeos@chonnam.ac.kr.
authors.forename: Keun-Bae
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult