Minimally invasive surgery for intra-articular calcaneus fractures: a 9-year, single-center, retrospective study of a standardized technique using a 2-point distractor. Anatomy The extensile lateral approach provides excellent fracture visualization and allows reduction of the displaced fracture fragments, but high complication rate has been described with this approach, so many studies favor the sinus tarsi approach. -, Benirschke SK, Sangeorzan BJ (1993) Extensive intraarticular fractures of the foot. Bethesda, MD 20894, Web Policies Epub 2017 Mar 9. Feng Y, Shui X, Wang J, Cai L, Yu Y, Ying X, Kong J, Hong J. BMC Musculoskelet Disord. The .gov means its official. This site needs JavaScript to work properly. Zhang H, Shen G, Xu Z, Gao J, Lai J, Yang K, Li X, Zou Y, Lai Z, Zhu Y, Jie K. Int Orthop. The results, i.e. 2001;7:7784. There were no major soft tissue complications. Sinus Tarsi Approach to Calcaneus ORIF Mahesh Bagwe, MD, (St. Louis, MO) presents cases using a minimally invasive sinus tarsi approach for treating calcaneal fractures. Our present study suggests that the minimally invasive sinus tarsi approach with our combined plate may be a safe and effective alternative for the operative treatment of type II and simple type III calcaneal fractures, with rare postoperative complications and excellent reduction capacity. A novel distractor-assisted reduction combined with the sinus tarsi approach for joint depression-type calcaneal fractures. Before sharing sensitive information, make sure youre on a federal Bethesda, MD 20894, Web Policies Dry arthroscopy can also assist in accurate joint reduction. Harvard Medical School, Boston, MA Incision used for sinus tarsi approach is 3-4 cm, made from the tip of the fibula toward the base of the fourth metatarsal. Please enable it to take advantage of the complete set of features! This is a safe, simple incision, but the surgeon must look for the sural nerve. PMC Disclaimer, National Library of Medicine and transmitted securely. Fischer S, Meinert M, Neun O, Colcuc C, Gramlich Y, Hoffmann R, Manegold S. Arch Orthop Trauma Surg. Recent evidence favoring sinus tarsi rather than the extensile lateral approach has shifted opinion toward this less invasive approach, which can be considered the new gold standard. Epub 2019 Jan 24. [14] Moon J-S, Lee W-C. A comparison of extensile lateral approach and sinus tarsi approach for the Sanders type II calcaneal fracture. Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. J Orthop Surg Res. A literature search in the electronic databases of the Cochrane Library and Pubmed Medline, between January 1st 2000 to December 1st 2010, was conducted to identify studies in which the sinus tarsi approach or a modified sinus tarsi approach was utilized for the treatment of displaced intra-articular calcaneal fractures. Zhou HC, Yu T, Ren HY, Li B, Chen K, Zhao YG, Yang YF. Before Bookshelf Treatment of calcaneal fractures in children by open reduction by sinus tarsi approach and K-wires fixation is a safe and effective method with low incidence of complications. Ivanov S, Stefanov A, Zderic I, Rodemund C, Schepers T, Gehweiler D, Dauwe J, Pastor T, Makelov B, Raykov D, Richards G, Gueorguiev B. Eur J Trauma Emerg Surg. Treatment of displaced intra-articular calcaneal fractures has changed numerous times in the last decades. 8600 Rockville Pike This approach is used for minimally invasive reductions and percutaneous fixation of displaced intraarticular calcaneal fractures. Please enable it to take advantage of the complete set of features! government site. 2018 May-Aug;26(3):2309499018792742. doi: 10.1177/2309499018792742. Sinus tarsi syndrome is when swelling and pain occur on the outside of the joint below the ankle. -, Atkins RM, Allen PE, Livingstone JA. Conclusions: Percutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations - a biomechanical human cadaveric analysis. PMC The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. Epub 2021 May 11. Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis Results show that, compared with ELA, STA is superior for treating calcaneal fractures due to anatomical reduction of the calcaneus, reduction of incision complications incidence, and shortened operative time and postoperative stay. Guo C, Xu Y, Li C, Li X, Wang Z, Cai M, Xu X. Int Orthop. 14 Gupta, reported on a modification of Palmer's approach, in which a straight incision was made 1 cm distal . 1998;19:856861. This approach minimizes soft tissue disruption, provides visualization of the posterior facet, and allows reproducible fracture reduction and fixation while protecting the lateral hindfoot angiosome. The Calc-Jak allows for medial/lateral, anterior/posterior, and superior/inferior translation of calcaneus fractures that can be locked in place using the cam levers. Epub 2020 Nov 4. -. Traumatic injury to the ankle/foot (such as an ankle sprain) or overuse (such as repetitive standing or walking) are the main causes of this syndrome. Bookshelf and transmitted securely. Healthcare professionals refer to this area between the ankle and heel bone as the sinus tarsi or . Methods: Operative techniques in open reduction and internal fixation of calcaneal fractures. Minimally invasive (sinus tarsi) approach for calcaneal fractures Treatment with our self-designed combined plate through a sinus tarsi approach may be safe and effective for type II and type III calcaneal fractures. Low Risk of Wound Complications With Sinus Tarsi Approach for Treatment of Calcaneus Fractures. Accessibility 2. for higher risk patients or those with concomitant fractures that could be addressed simultaneously. Resource Type: Presentation Videos Presenter: Mahesh Bagwe, MD The incision is exposed better with extensile lateral approach (ELA), while the sinus tarsi approach (STA) causes fewer complications. Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis. official website and that any information you provide is encrypted 2022 Jul-Aug;61(4):771-775. doi: 10.1053/j.jfas.2021.11.013. A review of 40 patients. What is claimed is: 1.A method to provide a non-binding allograft subtalar joint implant into a person's foot proximate to the ankle comprising: surgically accessing a canal within a person's foot proximate to the person's talus and calcaneus bones, the canal having a width between the talus and calcaneus bones; selecting a pre-formed allograft rod plug having a diameter of about the canal . official website and that any information you provide is encrypted Ligaments and tendons The peroneal tendons are on the lateral side of the calcaneus. Comparing less invasive plate fixation versus screw fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach. The https:// ensures that you are connecting to the 2022 Nov 12. doi: 10.1007/s00264-022-05625-5. An average complication rate of minor wound complications of 4.1% was reported and major wound complications in 0.7%. doi: 10.1097/MD.0000000000026717. Surgical management of calcaneal fractures. Zhang H, Shen G, Xu Z, Gao J, Lai J, Yang K, Li X, Zou Y, Lai Z, Zhu Y, Jie K. Int Orthop. Indications, surgical technique, and possible pitfalls are discussed. Int J Environ Res Public Health. Cho J, Kim J, Kang EM, Lee JS, Min TH, Won SH, Yi Y, Chun DI. Wallace B, Chhabra A, Narayanan A, O'Neill D, Xi Y, Van Pelt M, Wukich DK, Liu G, Sanders D, Lalli T. J Foot Ankle Surg. Displaced intra-articular calcaneal fractures are among the most difficult articular fractures to treat, with a high rate of potential complications. It may also occur if the person has a pes planus or an over-pronated foot, which can cause compression in the sinus tarsi. Minimal invasive sinus tarsi approach for calcaneal fracture (Sanders type 2 /3) - YouTube 0:00 / 17:25 Sign in to confirm your age This video may be inappropriate for some users. Feng Y, Shui X, Wang J, Cai L, Yu Y, Ying X, Kong J, Hong J. BMC Musculoskelet Disord. Zhang H, Shen G, Xu Z, Gao J, Lai J, Yang K, Li X, Zou Y, Lai Z, Zhu Y, Jie K. Int Orthop. Approach; Calcaneus; Fractures; Sinus tarsi; Surgical. Disclaimer, National Library of Medicine Sinus tarsi approach for calcaneus fractureIntroduce by - YouTube Sign in to confirm your age This video may be inappropriate for some users. Soft tissue management, as well as pre- and postoperative timing and discharge management can be improved with the nail. However, because of the smaller surgical window, visualization is more . Lateral radiograph with superimposed line drawings of approaches and nerves. Purpose: The image shows a foot 14 days after injury appropriate for surgery, with the wrinkle sign present. The results in the literature show overall similar functional outcome compared with the extended lateral approach, however with a significant reduction in wound complications. Please enable it to take advantage of the complete set of features! Sanders classification. Early surgery may be appropriate for percutaneous sinus tarsi reduction if foot swelling is not severe. HHS Vulnerability Disclosure, Help See this image and copyright information in PMC. THE. FOIA This site needs JavaScript to work properly. 2022 Nov 12. doi: 10.1007/s00264-022-05625-5. Accessibility Clipboard, Search History, and several other advanced features are temporarily unavailable. DISCUSSION AND CONCLUSIONS The results with the locking calcaneus nail and sinus tarsi approach suggest, that similar treatment results can be achieved as with plate osteosynthesis and an extended lateral approach. Epub 2020 Jul 23. government site. The Percutaneous Calcaneal Fracture Plates feature nine plate options and include radiolucent percutaneous guides. Go to: Acknowledgements None Funding sharing sensitive information, make sure youre on a federal Before Bethesda, MD 20894, Web Policies This site needs JavaScript to work properly. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Oct;141(10):1691-1699. doi: 10.1007/s00402-020-03649-3. 2014 Feb 19;96(4):302-9. doi: 10.2106/JBJS.L.01215. Is important to restore calcaneus posterior facet anatomy as well as calcaneus width, length, and height. An official website of the United States government. 13 Later, Essex-Lopresti adopted a similar sinus tarsi incision to elevate depressed joint fragments. The sinus tarsi approach in displaced intra-articular calcaneal fractures Arch Orthop Trauma Surg. Careers. Femino JE, Vaseenon T, Levin DA, Yian EH. Foot Ankle Int. Bookshelf Copyright 2018 Elsevier Inc. All rights reserved. Alternative limited lateral surgical approaches have been described. Clipboard, Search History, and several other advanced features are temporarily unavailable. Use of intramedullary locking nail for displaced intraarticular fractures of the calcaneus: what is the evidence. The .gov means its official. The .gov means its official. 2021 Apr;141(4):611-617. doi: 10.1007/s00402-020-03530-3. A recent study has shown that preoperative doppler ultrasound showing non-patency of the lateral calcaneal artery is strongly . Copyright 2020 Elsevier Inc. All rights reserved. began using in 1999 based on the technique described by Gupta et al. The front incision was directed toward lateral wall bone of anterior process of calcaneus. 2015 Mar 19;16:63. doi: 10.1186/s12891-015-0519-0. Epub 2018 Oct 5. The sinus tarsi approach is a key surgical technique in the armamentarium for calcaneus fracture management. Materials and methods: Published trials comparing ELA and STA in calcaneal fractures were included in our analysis. The average Coleman methodology score was 56.8 (range 39-72) points. Orthop Surg. Online ahead of print. HHS Vulnerability Disclosure, Help Medicine (Baltimore). 2018 Sep 24;13(1):243. doi: 10.1186/s13018-018-0943-6. It is smaller and is not compromising any skin on the lateral side of the foot. Would you like email updates of new search results? Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures. Method: Epub 2017 Mar 9. Int J Environ Res Public Health. functional outcome and complication rates, of the sinus tarsi approach compare similarly or favourably to the extended lateral approach. MeSH Bernasconi A, Iorio P, Ghani Y, Argyropoulos M, Patel S, Barg A, Smeraglia F, Balato G, Welck M. Arch Orthop Trauma Surg. Pflger P, Zyskowski M, Greve F, Kirchhoff C, Biberthaler P, Crnlein M. Front Surg. Skin blisters should be observed and carefully protected. Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. J Orthop Surg Res. Injury. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated. 2021 Sep;45(9):2231-2237. doi: 10.1007/s00264-020-04867-5. Displaced intra-articular calcaneal fractures treated in a minimally invasive fashion: longitudinal approach versus sinus tarsi approach. Recently, the limited incision sinus tarsi approach has gained traction and is now commonly used at our institution for the treatment of calcaneus fractures. HHS Vulnerability Disclosure, Help doi: 10.1046/j.1460-9584.2001.00242.x. Older patients and those who are diagnosed with type IV calcaneal factures, besides those presented with more delay, are more associated with unfavorable complications. 2021. Federal government websites often end in .gov or .mil. government site. But sometimes swelling precludes early surgery and great patience is required to optimize the local surgical environment. The VAS and AOFAS scores were correlated with the degree of reduction of the posterior facet joint and the amount of Bohler angle restoration. 2017 Feb;9(1):77-85. doi: 10.1111/os.12310. Introduction Calcaneal fractures are probably the most common fractures in the tarsal bones, accounting for 60% of all tarsal fractures 1. Careers. Howev. Disclaimer, National Library of Medicine Level of evidence IV. Syros A, Perez J, Hodgens BH, Boden AL, Constantinescu DS, Smith B, Davies JP, Steinlauf S. J Orthop. 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. The site is secure. 2022 Aug;48(4):3305-3315. doi: 10.1007/s00068-022-01901-6. Currently, less invasive surgery has reemerged and is increasingly used. Line drawing of a semi-coronal image of the calcaneus showing all, Extended lateral approach versus sinus tarsi approach. The site is secure. 2021 Oct 2;18(19):10400. doi: 10.3390/ijerph181910400. 2016 Jul 15;17:288. doi: 10.1186/s12891-016-1122-8. Keywords: It combines the open approach to the subtalar joint with percutaneous reduction of the overall shape of the calcaneus. r, the optimal incision approach is still controversial. 1999;9:239246. Once the subtalar joint is entered, this small incision allows the surgeon to have direct vision of the subtalar joint and the surgeon can reduce and internally fix any fracture lines. Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach. The sinus tarsi approach may be a good option to treat intra-articular calcaneal fractures in select cases (Sanders type II and III) while preventing the major soft tissue complications of the extended lateral approach. - YouTube 0:00 / 7:55 Sign in to confirm your age This video may be inappropriate for some users. Lin J, Xie C, Chen K, Sun S, Zhou K, Zhou C, Shui X, Kong J. Int Orthop. The lateral incision of calcaneus was made via sinus tarsi approach beginning from the anterolateral corner of the tip of the lateral malleolus, through sinus tarsi, calcaneocuboid joint and extending to the proximal cuboid. doi: 10.1016/S1048-6666(99)80022-6. This site needs JavaScript to work properly. Bookshelf Oper Tech Orthop. This article deals with the sinus tarsi approach in which the reduction is fixated using screws only. Would you like email updates of new search results? We describe an extensile sinus tarsi based approach, for open reduction of displaced calcaneal fractures that the senior author (J.F.) sharing sensitive information, make sure youre on a federal 2022 Nov 12. doi: 10.1007/s00264-022-05625-5. Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis. This chapter will go over the indications and surgical technique of the sinus tarsi approach for fixation of calcaneus fractures using a . Is important to restore calcaneus posterior facet anatomy as well as calcaneus width, length, and height. Femino JE, Vaseenon T, Levin DA, Yian EH. Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture. Correct timing of surgery is the most important factor in preventing local wound complication. The image shows a foot 3 days after serious trauma, which is inappropriate for surgery. Epub 2020 Oct 27. Connect with peers, learn from experts. The extensile lateral approach provides excellent fracture visualization and allows reduction of the displaced fracture fragments, but high complication rate has been described with this approach, so many studies favor the sinus tarsi approach. 2018 Sep 24;13(1):243. doi: 10.1186/s13018-018-0943-6. In conclusion, the minimally invasive sinus tarsi approach has relatively low complications and excellent clinical and radiological outcomes. 2001;32:631632. Surgical experience as a decisive factor for the outcome of calcaneal fractures using locking compression plate: results of 3years. 2017 Feb;9(1):77-85. doi: 10.1111/os.12310. It is common for this approach to be undertaken when the calcaneal fracture is of a simpler classification. An official website of the United States government. and transmitted securely. BMC Musculoskelet Disord. Before Three cases of minor soft tissue complications healed with no need for subsequent procedures. The quality . The mean union time was 3.2 months (range 3-4 months). a Pre-operative, Sanders classification. Disclaimer, National Library of Medicine 2021 May 28;8:620964. doi: 10.3389/fsurg.2021.620964. Note the position of the retinaculum and of the fibulocalcaneal and talocalcaneal ligaments. Would you like email updates of new search results? The aim of this systematic review was to combine the results of studies using the sinus tarsi approach, which is the most frequently applied limited lateral approach. Wallace B, Chhabra A, Narayanan A, O'Neill D, Xi Y, Van Pelt M, Wukich DK, Liu G, Sanders D, Lalli T. J Foot Ankle Surg. The site is secure. TraumaThe lateral calcaneal artery provides critical arterial supply for healing of the extensile lateral approach to the calcaneus. Disclosure The authors have nothing to disclose. A novel distractor-assisted reduction combined with the sinus tarsi approach for joint depression-type calcaneal fractures. Due to the shorter incision, and more proximal location of the incision, wound complications are less common [ 2 ]. An official website of the United States government. 2020 Mar-Apr;59(2):356-366. doi: 10.1053/j.jfas.2019.08.007. Federal government websites often end in .gov or .mil. FOIA Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. J Orthop Surg Res. Mid- to long-term outcome in patients treated with a mini-open sinus-tarsi approach for calcaneal fractures. Sinus Tarsi Approach with Subcutaneously Delivered Plate Fixation for Displaced Intra-Articular Calcaneal Fractures. 2021 Aug 6;100(31):e26717. Tendons and sural nerve are protected inferiorly. Online ahead of print. Int Orthop. Sinus tarsi approach to the calcaneus Select a chapter 1. Authors PMC Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach. Clin Orthop Relat Res 292:128134 8600 Rockville Pike Unable to load your collection due to an error, Unable to load your delegates due to an error. Minimally invasive approaches, including the sinus tarsi approach, are being frequently used to treat displaced intra-articular calcaneus fractures with promising results and the literature has shown that through the use of these approaches, there has been a decreased rate of wound complications, hematoma formation, surgical time, and equivalent functional outcomes to the extensile lateral . BMC Musculoskelet Disord. 2021 Oct 2;18(19):10400. doi: 10.3390/ijerph181910400. 2022 Sep 14;34:282-287. doi: 10.1016/j.jor.2022.09.009. 2021 Jun 15;35(6):729-733. doi: 10.7507/1002-1892.202101029. They account for 1 to 2% of all fractures and 60% of all tarsal fractures. Careers. Epub 2021 Dec 3. Level of evidence IV. 2019 Sep;43(9):2141-2149. doi: 10.1007/s00264-019-04318-w. Epub 2019 Mar 22. 2021 Sep;45(9):2337-2346. doi: 10.1007/s00264-021-05094-2. On the basis of the delay time from injury to surgery, patients were classified into 4 groups: immediate (0-3 days), early (4-6 days), intermediate (7-14 days), and late (14-18 days). Foot Ankle Surg. -, Abidi NA, Dhawan S, Gruen GS, Vogt MT, Conti SF. Example of displaced intra-articular calcaneal fracture treated via sinus tarsi approach. sharing sensitive information, make sure youre on a federal Bethesda, MD 20894, Web Policies Kir MC, Ayanoglu S, Cabuk H, Dedeoglu SS, Imren Y, Karslioglu B, Yuce A, Gurbuz H. J Orthop Surg (Hong Kong). Indications This approach is used for minimally invasive reductions and percutaneous fixation of displaced intraarticular calcaneal fractures. A total of eight case series reporting on 256 patients with 271 calcaneal fractures was identified. The need for a secondary subtalar arthrodesis occurred at an average rate of 4.3%. An official website of the United States government. Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: A prospective randomized study Show detailsHide details Mustafa C Kir Semih Ayanoglu Haluk Cabuk Suleyman S Dedeoglu Yunus Imren Bulent Karslioglu Clipboard, Search History, and several other advanced features are temporarily unavailable. 2016 Jul 15;17:288. doi: 10.1186/s12891-016-1122-8. All approaches to the calcaneous Extended lateral approach to the calcaneus See details Sinus tarsi approach to the calcaneus See details MIO posterior approach to the calcaneus See details Medial approach to the calcaneus See details Mio lateral approach to the calcaneus See details AO Davos Courses 2022 Connect with peers, learn from experts. Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture. Accessibility 8600 Rockville Pike Treatment with our self-designed combined plate through a sinus tarsi approach may be safe and effective for type II and type III calcaneal fractures. Keywords: Dec 416, 2022, Revised proximal femur module is now online. 2020 Nov 14;21(1):753. doi: 10.1186/s12891-020-03762-9. [16] Schuberth JM, Cobband MD . Online ahead of print. Displaced intra-articular calcaneal fractures are among the most difficult articular fractures to treat, with a high rate of potential complications. and transmitted securely. 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