Percutaneous reduction and Kirschner pin flxation through sinus tarsi approach for the treatment of Sanders type III calcaneal fracture

Abstract

To investigate clinical effect of percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type III calcaneal fracture. Totally 22 patients (22 feet) with Sanders III calcaneal fracture were treated with percutaneous reduction and Kirschner pin flxation through sinus tarsi approach form September 2013 to December 2015. Among them, including 18 males and 4 females; aged from 20 to 65 years old with an average of (41.73±12.46) years old. Böhler angle, Gissane angle and calcaneal width before and after operation were observed and compared, Maryland scoring system was used to evaluate curative effect; postoperative complications were recorded. All patients were followed up from 18 to 36 months with an average of (27.05±4.92) months. All fractures healed well with an average of (10.73±1.24) weeks. Böhler angle before operation (11.36±5.92) improved to (33.36±3.99) after operation, and had significant differences(P<0.05); there was significant difference of Gissane angle between preoperation (99.23±8.61) and postoperation (114.64±6.93); calcaneal width was improved from (46.59±1.40) mm before operation to (42.15±0.75) mm at 3 months after operation (P<0.05). Maryland score was (95.05±6.86) points, 16 patients obtained excellent results, 5 patients moderate, and 1 patient poor. No inflammation, flap margin necrosis and osteomyelitis occurred. Compared with conventional internal fixation through L-shape incision, percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type III calcaneal fracture obtained satisfied clinical effects, and has advantages of invasive trauma, simple operation, easy to remove and less complication. Meanwhile, careful operation and identification should be done during sinus tarsi approach operation to protect sural nerve and tendon.