Short to medium term functional and radiological outcomes and complication rates for Intraarticular Calcaneum fracture fixation done using Sinus Tarsi Approach

A. Gopinathannair, P. Prasad, B. Ayyaswamy, A. Anand

Introduction: The extensile lateral approach for calcaneum fracture fixation has high complication rates of about 25%- 30%. Sinus Tarsi approach is a minimally invasive surgical technique for fixing calcaneal fractures with minimal wound complications.

Aim: The study is to access the Short to Medium term Functional and Radiological outcome and complication rates for Intra-articular Calcaneum fracture fixation using Sinus Tarsi Approach.

Methods: Retrospective study of 27 patients with intra-articular displaced Calcaneum fractures fixed using Sinus Tarsi approach from 2015 - 2022. All patients had pre-operative radiographs, CT scans and appropriate DVT prophylaxis. We used Sanders classification and Pre and post operative Bohlers angle measurements. The functional outcome was measured using MOxFQ scores and looked at complications rates including Sub-Talar fusion rates.

Results: Our study had a male to female ratio of 4:1 with mean age of 48 years (22 - 79) with 1 to 8 years follow up. Ten patients were active smokers. The mean pre operative Bohler’s angle was 9.41 +/- 8.2, achieved post operative Bohler’s angle was 27.5 +/- 5 with an improvement in the Bohler’s angle of 18 +/- 3.5, which is statistically significant (P value < 0.0001). The mean MOxFQ score is 55.93 ( 27.8 - 78.3). We had one patient with wound infection requiring implant exit. 8 patients had radiological evidence of arthritis but none required fusion.Most patients were able to return to their pre injury occupation apart from 5 patients.

Conclusion: Minimally invasive Calcaneal fracture fixations using sinus tarsi approach has shown significant restoration of bohlers angle with minimal complication rate. Although 30% of patients has got mild to moderate arthritis, none of the patients needed revision in a short to medium term follow up. Patients had fair to good functional outcome with good radiological outcome and less revision rates.