Combined Extensile Medial and Sinus Tarsi Approaches for Intra-Articular Calcaneus Fractures

Abstract Background This study aimed to evaluate the clinical efficacy of combining the extensile medial approach with the sinus tarsi approach for treating intra-articular calcaneus fractures. Methods The outcomes of 11 patients treated with the combined extensile medial and sinus tarsi approaches were evaluated. Specifically, the length, width, height, Böhler´s angle, Gissane angle, varus angle of the calcaneus body, intraoperative bleeding, incision complications and the American Orthopaedic Foot and Ankle Society (AOFAS) score were assessed. Results The anatomical structure and articular surface of the calcaneus were recovered at the final follow-up. The mean values (final follow-up vs. preoperatively) were 83.4 ± 4.3 mm vs. 79.9 ± 4.6 mm for length (p < 0.05), 43.5 ± 2.5 mm vs. 48.3 ± 2.3 mm for height (p < 0.001), 50.2 ± 4.1 mm vs.42.0 ± 2.6 mm for width (p < 0.001), 11.5 ± 7.6° vs. 29.1 ± 8.7° for Böhler´s angle (p < 0.001), 117.7 ± 11.7° vs. 124.1 ± 6.3° for Gissane angle (p > 0.05) and 8.5 ± 4.0° vs. 2.8 ± 2.0° for varus angle (p < 0.001). The mean AOFAS score at the final follow-up was 91.3 ± 7.6. Conclusion Utilising the extensile medial approach with the sinus tarsi approach allows for better visualisation and reduction of the medial wall and joint surfaces under direct and indirect visions. Postoperative joint and bone alignment were restored. Thus, this combined approach represents a novel and effective method deserving clinical promotion. Trial registration Not applicable (retrospective study).