Journal Article

Screw-only Fixation of Calcaneal Fractures Using the Sinus Tarsi Approach/Kalkaneus Kiriklarinin Sinus Tarsi Yaklasimi ile Sadece Vidalar Kullanilarak Tespiti

Aybar, Ahmet, Özden, Erdem

2023

Overview

Objective: Calcaneus is the most commonly fractured tarsal bone. This type of fracture may result from high-energy trauma or axial loading. The ideal treatment method for calcaneal fractures remains controversial in terms of surgical approach and the material that will be used for fracture fixation. This study aims to evaluate the outcomes of screw-only fixation in intra-articular calcaneal fractures using the sinus tarsi approach. Methods: Patients who were treated between 2014 and 2021 for calcaneal fractures were retrospectively investigated. Functional outcomes were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot-ankle score, and Gissane and Böhler angles were measured and compared. Results: The study included 32 patients (23 male, 9 female) who underwent screw fixation through the sinus tarsi approach for intra-articular calcaneal fractures. The mean age of the patients was 45.2 years. The fractures were classified according to the Sanders Classification, with 15 patients having type 2 fractures, 12 with type 3 fractures, and five with type 4 fractures. AOFAS hindfoot-ankle score revealed nine patients achieving excellent results, 14 patients achieving good results, and nine patients achieving fair results. AOFAS scores were lower in patients with Sanders type 4 fractures when compared to type 3 and type 2 fractures (p=0.005 and p<0.001 respectively). Conclusion: This study provides evidence supporting the favorable results of the sinus tarsi approach using screw-only fixation for treating intra-articularcalcaneal fractures. Keywords: Sinus tarsi, screw-only fixation, mini incision, calcaneus, Sanders type 4 Amaç: Kalkaneus, yüksek enerjili travma veya aksiyel yükleme sonucunda en sik kirilan tarsal kemiktir. Kalkaneal kiriklarin ideal tedavi yöntemi, cerrahi yaklasim ve kirik fiksasyonunda kullanilacak malzeme açisindan hala tartismalidir. Bu çalisma, sinüs tarsi yaklasimi kullanilarak intraartiküler kalkaneal kiriklarda sadece vida fiksasyonunun sonuçlarini degerlendirmeyi amaçlamaktadir. Yöntemler: 2014-2021 yillari arasinda kalkaneal kirik tanisiyla tedavi edilen hastalar geriye dönük olarak incelendi. Fonksiyonel sonuçlar Amerikan Ortopedik Ayak ve Ayak Bilegi Dernegi (AOFAS) ayak bilegi-ard ayak skoru kullanilarak degerlendirildi ve Gissane ve Böhler açilari ölçüldü ve karsilastirildi. Bulgular: Çalismaya, intraartiküler kalkaneal kiriklar için sinüs tarsi yaklasimiyla vida ile tespit yapilan 32 hasta (23 erkek, 9 kadin) dahil edildi. Hastalarin yas ortalamasi 45,2 yildi. Kiriklar, Sanders Siniflandirmasi'na göre siniflandirildi ve 15 hastada tip 2 kirik, 12 hastada tip 3 kirik ve bes hastada tip 4 kirik saptandi. AOFAS ayak bilegi-ard ayak skoru sonuçlarina göre, dokuz hastada mükemmel, 14 hastada iyi ve dokuz hastada orta sonuç elde edildi. AOFAS skorlari, Sanders tip 4 kiriklari olan hastalarda tip 3 ve tip 2'ye göre daha düsük bulundu (sirasiyla p=0,005, p<0,001). Sonuç: Bu çalisma, intraartiküler kalkaneal kiriklarin tedavisinde sinüs tarsi yaklasimi kullanilarak sadece vida ile tespitin olumlu sonuçlarini destekleyen kanitlar sunmaktadir. Anahtar kelimeler: Sinüs tarsi, sadece vidalar ile tespit, mini insizyon, kalkaneus, Sanders tip 4

• Publisher: Galenos Yayinevi Tic. Ltd
• Subject: Foot / Heel bone / Injuries / Internal fixation in fractures / Methods