Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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The Sinus Tarsi Approach for the Treatment of Intra-Articular Calcaneal Fractures

족근동 접근법을 이용한 관절 내 종골 골절의 치료

  • Sato, Toru (Department of Orthopaedic Surgery, Okayama Medical Center) ;
  • Shiota, Naofumi (Department of Orthopaedic Surgery, Okayama Medical Center) ;
  • Tetsunaga, Tomonori (Department of Orthopaedic Surgery, Okayama Medical Center) ;
  • Kim, Bom Soo (Department of Orthopaedic Surgery, Inha University School of Medicine)
  • ;
  • ;
  • ;
  • 김범수 (인하대학교 의학전문대학원 정형외과학교실)
  • Received : 2013.10.30
  • Accepted : 2013.11.12
  • Published : 2013.12.15
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Abstract

Open reduction and internal fixation is currently considered as a gold standard of treatment in most of the intra-articular calcaneal fractures. Among various different approaches, extensile lateral approach is the most popular since it provides good exposure to the subtalar joint. However, wide skin incision followed by extensive soft tissue dissection leading to increased risk of wound breakdown is the most serious drawback. Sinus tarsi approach, a minimal invasive technique to approach the subtalar joint and reduce the intra-articular calcaneal fractures, provides good clinical outcome and less wound complications compared to the extensile lateral approach. This article introduces the surgical technique and review of the literature regarding the sinus tarsi approach.

Keywords

References

  1. Bae S. Complications of calcaneal fractures. J Korean Foot Ankle Soc. 2013;17:84-92.
  2. Schepers T. The sinus tarsi approach in displaced intraarticular calcaneal fractures: A systematic review. Int Orthop. 2011;35:697-703. https://doi.org/10.1007/s00264-011-1223-9
  3. Chun S, Kim HJ. Calcaneal fractures-extended lateral approach. J Korean Foot Ankle Soc. 2013;17:79-83.
  4. Abidi NA, Dhawan S, Gruen GS, et al. Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures. Foot Ankle Int. 1998;19:856-61. https://doi.org/10.1177/107110079801901211
  5. Lim EV, Leung JP. Complications of intraarticular calcaneal fractures. Clin Orthop Relat Res. 2001;391:7-16. https://doi.org/10.1097/00003086-200110000-00003
  6. PALMER I. The mechanism and treatment of fractures of the calcaneus; open reduction with the use of cancellous grafts. J Bone Joint Surg Am.1948;30A:2-8.
  7. Wiley WB, Norberg JD, Klonk CJ, et al. "Smile" incision: An approach for open reduction and internal fixation of calcaneal fractures. Foot Ankle Int. 2005;26:590-2. https://doi.org/10.1177/107110070502600802
  8. Schepers T, Kieboom BC, Bessems GH, et al. Subtalar versus triple arthrodesis after intra-articular calcaneal fractures. Strategies Trauma Limb Reconstr. 2010;5:97-103. https://doi.org/10.1007/s11751-010-0084-x
  9. Gould N. Lateral approach to sinus tarsi. Foot Ankle. 1983;3:244-6. https://doi.org/10.1177/107110078300300412
  10. ESSEX-LOPRESTI P. The mechanism, reduction technique, and results in fractures of the os calcis. Br J Surg. 1952;39:395-419. https://doi.org/10.1002/bjs.18003915704
  11. Rammelt S, Amlang M, Barthel S, et al. Percutaneous treatment of less severe intraarticular calcaneal fractures. Clin Orthop Relat Res. 2010;468:983-90. https://doi.org/10.1007/s11999-009-0964-x
  12. Benirschke SK, Sangeorzan BJ. Extensive intraarticular fractures of the foot. surgical management of calcaneal fractures. Clin Orthop Relat Res. 1993;292:128-34.
  13. Carr JB. Surgical treatment of intra-articular calcaneal fractures: A review of small incision approaches. J Orthop Trauma. 2005;19:109-17. https://doi.org/10.1097/00005131-200502000-00007
  14. Burdeaux BD. Calcaneus fractures: Rationale for the medial approach technique of reduction. Orthopedics. 1987;10: 177-87.
  15. Romash M. Open reduction and internal fixation of comminuted intra-articular fractures of the calcaneus using the combined medial and lateral approach. Oper Tech Orthop. 1994;4:157-64. https://doi.org/10.1016/S1048-6666(06)80128-X
  16. Patnaik V, Singla R, Gupta P. Surgical incisions-their anatomical basis, part III - lower limb. J Anat Soc India. 2001;50:48-58.
  17. Park IH, Song KW, Shin SI, et al. Displaced intra-articular calcaneal fracture treated surgically with limited posterior incision. Foot Ankle Int. 2000;21:195-205. https://doi.org/10.1177/107110070002100303
  18. Ebraheim NA, Elgafy H, Sabry FF, et al. Sinus tarsi approach with trans-articular fixation for displaced intraarticular fractures of the calcaneus. Foot Ankle Int. 2000;21:105-13. https://doi.org/10.1177/107110070002100203
  19. Femino JE, Vaseenon T, Levin DA, et al. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: The limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery. Iowa Orthop J. 2010;30:161-67.
  20. Geel CW, Flemister AS,Jr. Standardized treatment of intraarticular calcaneal fractures using an oblique lateral incision and no bone graft. J Trauma. 2001;50:1083-9. https://doi.org/10.1097/00005373-200106000-00017
  21. Gupta A, Ghalambor N, Nihal A, et al. The modified palmer lateral approach for calcaneal fractures: Wound healing and postoperative computed tomographic evaluation of fracture reduction. Foot Ankle Int. 2003;24:744-53. https://doi.org/10.1177/107110070302401003
  22. Hospodar P, Guzman C, Johnson P, et al. Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach. Orthopedics. 2008;31:1112. https://doi.org/10.3928/01477447-20081101-08
  23. Kikuchi C, Charlton TP, Thordarson DB. Limited sinus tarsi approach for intra-articular calcaneus fractures. Foot Ankle Int. Published online October 22, 2013; doi:10.1177/ 1071100713510267.
  24. Kline AJ, Anderson RB, Davis WH, et al. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int. 2013;34:773-80. https://doi.org/10.1177/1071100713477607
  25. Mostafa MF, El-Adl G, Hassanin EY, et al. Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach. Strategies Trauma Limb Reconstr. 2010;5:87-95. https://doi.org/10.1007/s11751-010-0082-z
  26. Nosewicz T, Knupp M, Barg A, et al. Mini-open sinus tarsi approach with percutaneous screw fixation of displaced calcaneal fractures: A prospective computed tomographybased study. Foot Ankle Int. 2012;33:925-33. https://doi.org/10.3113/FAI.2012.0925
  27. Weber M, Lehmann O, Sagesser D, et al. Limited open reduction and internal fixation of displaced intra-articular fractures of the calcaneum. J Bone Joint Surg Br. 2008;90:1608-16.