Treatment of intra articular fracture calcaneus using sinus tarsi approach, bone block substitute, and screws

Objective To evaluate the results of fixation of intra articular calcaneus fracture using Sinus Tarsi Approach, bone block substitute, and screws fixation. Background Minimal invasive techniques for treatment calcaneus fractures have developed to overcome soft tissue complications associated with the traditional lateral approach. Sinus Tarsi approach has the advantage of visualization of posterior part of subtalar joint. Methods All patients underwent preoperative calcaneal lateral and axial radiographs and CT scan of the injured foot. The injured type was graded according to the Sanders classification on the basis of the CT scan findings. Bohler and Gissane angles were measured as anatomical parameters before surgery. Sinus Tarsi Approach was done for all patients, in addition to use of percutaneous screws fixation and bone block graft substitute. Results A total of 17 patients were included in our study. The mean age was 37.8 years. At the end of follow-up, radiological evaluation was done by measuring the Bohler angle and the angle of Gissan. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score was calculated at the end of the follow-up for all cases. Excellent results were found in7 patients, good results in 8 patients and fair results in only 2 patients. There was a statistically significant improvement of Bohler angle at the end of the follow-up. Conclusion Treatment of intra articular calcaneal fractures using Sinus Tarsi Approach with a bone block substitute and screws can provide satisfactory clinical outcomes.