Minimally Invasive Sinus Tarsi Approach for Open Reduction and Internal Fixation of Calcaneal Fractures: Complications, Risk Factors, and Outcome Predictors.

ABSTRACT

Open reduction and internal fixation of displaced intraarticular calcaneal fractures remain the gold standard of treatment, but the traditional extensile approach has been associated with relatively frequent complications. The current study aims to evaluate the less invasive sinus tarsi approach and to elaborate on the associated complications, risk factors, and outcome predictors. A retrospective observational study was carried out among 39 patients diagnosed with calcaneal fractures that were operatively treated between January 2019 and January 2020 at a level-one trauma center in Riyadh, Saudi Arabia. Patients were assessed regarding the complications, pre- and postoperative Bohler's angle, Gissane's angle, calcaneal height, and return to baseline function. Patients older than 60 years show significantly more complications compared to younger patients (p < 0.05). Type IV calcaneal fracture, according to Sander's classification, showed significantly more complications than other types (p < 0.05). There were significant variations in pre- and postoperative Bohler's angle and calcaneal height (p < 0.05). These variations apply to the Gissane's angle but do not rise to significant results (p > 0.05). Furthermore, the current study reports a significant moderate direct correlation between delay time and complication incidence (p < 0.05). In conclusion, the minimally invasive sinus tarsi approach has relatively low complications and excellent clinical and radiological outcomes. Older patients and those who are diagnosed with type IV calcaneal factures, besides those presented with more delay, are more associated with unfavorable complications.