Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: A meta-analysis

Abstract

Background: Operative management of displaced, intra-articular calcaneal fractures is associated with improved functional outcomes but associated with frequent complications due to poor soft tissue healing. The use of a minimally invasive sinus tarsi approach to the fixation of these fractures may be associated with a lower rate of complications and therefore provide superior outcomes without the associated morbidity of operative intervention. Methods: We reviewed four prospective and seven retrospective trials that compared the outcomes from the operative fixation of displaced intra-articular calcaneal fractures via either an extensile lateral approach or minimally invasive fixation via a sinus tarsi approach. Results: Patients managed with a sinus tarsi approach were less likely to suffer complications (OR=2.98, 95% CI=1.62-5.49, p=0.0005) and had a shorter duration of surgery (OR=44.29, 95% CI=2.94-85.64, p=0.04). Conclusion: In displaced intra-articular calcaneal fractures, a minimally invasive sinus tarsi approach is associated with a lower complication rate and quicker operation duration compared to open reduction and internal fixation via an extensile lateral approach.