The clinical outcomes comparison of limited open reduction via a sinus tarsi approach and open reduction internal fixation via a lateral extensile L-shape incision for the treatment of Sanders type II calcaneal fracture

Abstract

Objective To evaluate the clinical outcomes of limited open reduction via sinus tarsi approach and traditional open reduction internal fixation of the treatment for Sanders type Ⅱ calcaneal fracture.Methods Between February 2010 and February 2011,30 patients were enrolled into our study and were divided into minimal invasive and traditional groups randomly.Each group consisted of 15 patients.When soft tissue swelling subsided,the patients of mininal invasive group were performed a limited ORIF via a sinus tarsi incision,while those traditional groups were performed ORIF via a classical lateral extensile L-shape approach.X-rays were taken in the regular follow-up,B(o)hler and Gissane angle were measured.The final curative effect was comprehensively assessed according to visual analogue scale (VAS),the ankle and hind-foot score of American Orthopaedic Foot and Ankle Society (AOFAS) and SF-36 at the last follow-up,with the complications recorded.Results The average time of the follow-up was 16.9 nonths and 19.9months respectively in two groups.Superficial skin necrosis occurred in 2 cases in traditional group.X-ray demonstrated bone union 3 months after the operation in both groups.And no implant failure occurred.The B(o)hler angle of minimal invasive group was 13.1°±3.8° and the traditional group was 14.9°±4.3°,the Gissane angle of minimal invasive group was 28.1°±7.8° and the traditional group was 26.2°±8.2°.The average AOFAS ankle and hindfoot score of minimal invasive group at final follow-up was 91.2±15.9,and the average VAS score was 1.7±1.3,while the traditional group was 82.4±14.7 and 1.9±2.1 respectively.But SF-36 score in minimal invasive group (79.5±12.1) was higher than that in traditional group (70.2±12.4).Four patients in minimal invasive group and 15 in traditional group suffered from varying degrees of subtalar joint stiffness.Conclusion No significant difference was found between the two groups in the short-term efficacy of the treatment for Sanders type Ⅱ calcaneal fracture.However,minimal invasive technique has the advantages of lower soft tissue complication rate and lower suhtalar joint stiffness rate. Key words: Calcaneus; Fractures; Prospective studies