Clinical effect analysis of plate fixation and screw fixation via tarsal sinus approach in the treatment of Sander Ⅱ Ⅲand Ⅳ calcaneal fracture

Abstract Objective The aim of this study is to compare the efficacy of plate fixation via the tarsal sinus approach with screw fixation alone in treating Sander type II, III, and IV fractures. Method Between 2016 and 2023, a comprehensive study encompassing 73 patients and 78 feet with calcaneus fractures was conducted. The investigation compared the efficacy of open reduction plate fixation (ORPF) (18 cases) against open reduction screw fixation (ORSF) (60 cases). Parameters such as operation duration, intraoperative blood loss, hospital stay duration, postoperative imaging metrics (including calcaneal length, width, height, Bohler Angle, Gissane Angle, and Angle of calcaneus varus), postoperative complications, and the AOFAS score one year post-surgery were meticulously analyzed and compared across both treatment groups. Results No significant discrepancies were observed between the two groups concerning calcaneal dimensions, including length, width, height, Bohler Angle, Gissane Angle, and Angle of calcaneus varus post-operation (p > 0.05). Moreover, throughout the long-term postoperative monitoring period, no notable distinctions were evident in these parameters between the two groups. Notably, the ORSF group exhibited reduced intraoperative hemorrhage (p = 0.026), shorter procedural duration (p = 0.028), and fewer occurrences of postoperative complications such as pain or superficial infections. However, the incidence of long-term postoperative complications did not demonstrate statistical significance. Furthermore, there were no discernible variations in AOFAS scores between the groups at the latest follow-up assessment. Conclusion Both open reduction screw internal fixation and open reduction plate internal fixation have been shown to be effective methods for clinically treating calcaneal fractures, with both techniques yielding positive postoperative imaging results. However, internal fixation with open reduction screws has been found to have several advantages over open reduction plate internal fixation, including less bleeding, shorter operation time, and fewer short-term complications.