Comparison Between Sinus Tarsi Approach and Extensile Lateral Approach for Treatment of Closed Displaced Intra-Articular Calcaneal Fractures: A Multicenter Prospective Study

J Foot Ankle Surg. 2016 May-Jun;55(3):513-21. doi: 10.1053/j.jfas.2015.11.008. Epub 2016 Jan 23.


The purpose of our investigation was to prospectively review and compare the early outcomes of Sanders II and III closed displaced intra-articular calcaneal fractures (DIACFs) in a group of patients treated by open reduction and internal fixation with plate and screws using the extended lateral approach or the sinus tarsi approach (STA). Thirty-eight patients with DIACFs were prospectively enrolled and operatively treated using either the extended lateral approach or the STA. Patients underwent a careful clinical and radiographic examination and were evaluated according to the American Orthopaedic Foot and Ankle Society score, visual analog scale, and the Foot Function Index. The results from our study showed similar clinical and radiographic outcomes between the 2 groups. In our series, Sanders II and III DIACFs were sufficiently exposed using the STA to achieve anatomic reduction and stable fixation. The STA group had a lower incidence of wound complications (p ≥ .05), the surgical procedure was faster, and the waiting time to surgery was shorter (p ≤ .05). Despite the limited number of patients and the short follow-up period, our results suggest that the STA is a useful method for the treatment of DIACFs, with a low incidence of complications and results comparable to those for patients treated using the extended lateral approach.

Keywords: Sanders classification; calcaneus; posterior facet; subtalar joint; surgery.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Bone Plates
  • Bone Screws
  • Calcaneus / diagnostic imaging
  • Calcaneus / injuries*
  • Calcaneus / surgery
  • Female
  • Fracture Dislocation / surgery
  • Fracture Fixation, Internal / methods*
  • Fractures, Closed / surgery
  • Humans
  • Intra-Articular Fractures / diagnostic imaging
  • Intra-Articular Fractures / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Treatment Outcome
  • Young Adult