Outcome study of operative treatment of displaced intra-articular calcaneal fractures by sinus tarsi approach & extensile lateral approach

Abstract

Traditionally used extensile lateral approach for treatment of displaced intra- articular calcaneal fractures has reported high rate of soft tissue complications (30%). In attempt to lower the complication rates, various minimal invasive techniques were introduced likes Sinus tarsi approach etc. To study the clinical & functional outcome of operative treatment of displaced intra- articular calcaneal fractures by STA & ELA.This prospective study was conducted in a tertiary care teaching center for 1 year from July 2019 to June 2020 following clearance from institutional ethics committee (Human). Sander’s type 2 & 3 closed fracture included and open fractures, sander’s type 1 & 4, extra-articular fracture, severe osteoporotic bone and conditions affect the gait were excluded. 15 patients underwent STA and 15 patients underwent ELA. Clinico-radiological follow-up was done at 2, 6, 12 weeks and 6th month to assessed union, radiological outcome, functional outcome and complications. VAS for pain relief, AOFAS score for functional outcome.Most were working middle age male mainly due to fall from height and road traffic accidents. Sander’s type 2 and 3 were more common. STA had shorter operative time (54.20 ±4.48mins), less intra-operative blood loss (51.00 ±5.73ml) and less soft tissue complications (13.33%) compared to ELA (operative time = 70.80± 9.05mins, blood loss= 98.00 ±9.2ml, complications = 46.67%). Both groups had 100% union. STA had early pain relieved (at 6th weeks) but VAS score was similar in both groups at final outcome. No difference was observed in radiological parameters and AOFAS score at final follow-up.STA gives better result than ELA in operative treatment of sander’s type 2 and 3 calcaneal fractures.