Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures
Abstract Aims Which is the best extensile lateral (ELA) or sinus tarsi (STA) approach for osteosynthesis displaced intraarticular calcaneal fracture (DIACF) is still debatable. The current RCT’s primary objective was to compare the complications incidence after open reduction and internal fixation o...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-024-05345-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559258819198976 |
|---|---|
| author | Amr A. Fadle Ahmed A. Khalifa Peter Mamdouh Shehata Wael EL-Adly Ahmed Ekram Osman |
| author_facet | Amr A. Fadle Ahmed A. Khalifa Peter Mamdouh Shehata Wael EL-Adly Ahmed Ekram Osman |
| author_sort | Amr A. Fadle |
| collection | DOAJ |
| description | Abstract Aims Which is the best extensile lateral (ELA) or sinus tarsi (STA) approach for osteosynthesis displaced intraarticular calcaneal fracture (DIACF) is still debatable. The current RCT’s primary objective was to compare the complications incidence after open reduction and internal fixation of DIACFs through STA vs. ELA. The secondary objectives were the differences in intraoperative radiation exposure, time to fracture union, functional and radiological outcomes. Methods Between August 2020 and February 2023, 157 patients with Sanders type II and III fractures were randomly assigned to either ELA (81 patients with 95 fractures) or STA (76 patients with 91 fractures). The primary outcome was the incidence of complications. The secondary outcomes were Böhler’s and Gissane angles angle, fracture union, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Results No statistical differences between both groups regarding basic demographic data, injury characteristics, and fracture classification; however, patients in the STA group were operated upon significantly earlier (4.43 ± 7.37 vs. 7 ± 6.42 days, p = 0.001). STA’s operative time was significantly shorter (55.83 ± 7.35 vs. 89.66 ± 7.12 min, p < 0.05), and no statistical difference regarding intraoperative radiation exposure. The time to fracture union was significantly shorter in STA (6.33 ± 0.8 vs. 7.13 ± 0.7 weeks, p = 0.000). Skin complications (superficial or deep infection) and Subtalar osteoarthritis were significantly higher in ELA (18.9% vs. 3.3%, p = 0.001) and (32.6% vs. 9.9%, p = 0.001), respectively. The radiological parameters were significantly better in STA postoperatively and at the last follow up. The AOFAS scores were significantly better in STA (83.49 ± 7.71 vs. 68.62 ± 7.05, respectively, p = 0.000). Conclusion During osteosynthesis of Sanders type II and III DIACFs, STA is superior to ELA in terms of operating earlier, shorter operative time, fewer complications, and better radiological and functional outcomes. |
| format | Article |
| id | doaj-art-fc622984c0b5403cb76b73d334170cb3 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-fc622984c0b5403cb76b73d334170cb32025-01-05T12:41:22ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111210.1186/s13018-024-05345-zExtensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fracturesAmr A. Fadle0Ahmed A. Khalifa1Peter Mamdouh Shehata2Wael EL-Adly3Ahmed Ekram Osman4Orthopaedic Department, Assiut Faculty of Medicine, Assiut University Hospital, Assiut UniversityOrthopaedic Department, Qena Faculty of Medicine and University Hospital, South Valley UniversityOrthopaedic Department, Assiut Faculty of Medicine, Assiut University Hospital, Assiut UniversityOrthopaedic Department, Assiut Faculty of Medicine, Assiut University Hospital, Assiut UniversityOrthopaedic Department, Assiut Faculty of Medicine, Assiut University Hospital, Assiut UniversityAbstract Aims Which is the best extensile lateral (ELA) or sinus tarsi (STA) approach for osteosynthesis displaced intraarticular calcaneal fracture (DIACF) is still debatable. The current RCT’s primary objective was to compare the complications incidence after open reduction and internal fixation of DIACFs through STA vs. ELA. The secondary objectives were the differences in intraoperative radiation exposure, time to fracture union, functional and radiological outcomes. Methods Between August 2020 and February 2023, 157 patients with Sanders type II and III fractures were randomly assigned to either ELA (81 patients with 95 fractures) or STA (76 patients with 91 fractures). The primary outcome was the incidence of complications. The secondary outcomes were Böhler’s and Gissane angles angle, fracture union, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Results No statistical differences between both groups regarding basic demographic data, injury characteristics, and fracture classification; however, patients in the STA group were operated upon significantly earlier (4.43 ± 7.37 vs. 7 ± 6.42 days, p = 0.001). STA’s operative time was significantly shorter (55.83 ± 7.35 vs. 89.66 ± 7.12 min, p < 0.05), and no statistical difference regarding intraoperative radiation exposure. The time to fracture union was significantly shorter in STA (6.33 ± 0.8 vs. 7.13 ± 0.7 weeks, p = 0.000). Skin complications (superficial or deep infection) and Subtalar osteoarthritis were significantly higher in ELA (18.9% vs. 3.3%, p = 0.001) and (32.6% vs. 9.9%, p = 0.001), respectively. The radiological parameters were significantly better in STA postoperatively and at the last follow up. The AOFAS scores were significantly better in STA (83.49 ± 7.71 vs. 68.62 ± 7.05, respectively, p = 0.000). Conclusion During osteosynthesis of Sanders type II and III DIACFs, STA is superior to ELA in terms of operating earlier, shorter operative time, fewer complications, and better radiological and functional outcomes.https://doi.org/10.1186/s13018-024-05345-zCalcaneal fracturesExtensible lateral approachSinus tarsi approachcomplications |
| spellingShingle | Amr A. Fadle Ahmed A. Khalifa Peter Mamdouh Shehata Wael EL-Adly Ahmed Ekram Osman Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures Journal of Orthopaedic Surgery and Research Calcaneal fractures Extensible lateral approach Sinus tarsi approach complications |
| title | Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures |
| title_full | Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures |
| title_fullStr | Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures |
| title_full_unstemmed | Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures |
| title_short | Extensible lateral approach versus sinus tarsi approach for sanders type II and III calcaneal fractures osteosynthesis: a randomized controlled trial of 186 fractures |
| title_sort | extensible lateral approach versus sinus tarsi approach for sanders type ii and iii calcaneal fractures osteosynthesis a randomized controlled trial of 186 fractures |
| topic | Calcaneal fractures Extensible lateral approach Sinus tarsi approach complications |
| url | https://doi.org/10.1186/s13018-024-05345-z |
| work_keys_str_mv | AT amrafadle extensiblelateralapproachversussinustarsiapproachforsanderstypeiiandiiicalcanealfracturesosteosynthesisarandomizedcontrolledtrialof186fractures AT ahmedakhalifa extensiblelateralapproachversussinustarsiapproachforsanderstypeiiandiiicalcanealfracturesosteosynthesisarandomizedcontrolledtrialof186fractures AT petermamdouhshehata extensiblelateralapproachversussinustarsiapproachforsanderstypeiiandiiicalcanealfracturesosteosynthesisarandomizedcontrolledtrialof186fractures AT waeleladly extensiblelateralapproachversussinustarsiapproachforsanderstypeiiandiiicalcanealfracturesosteosynthesisarandomizedcontrolledtrialof186fractures AT ahmedekramosman extensiblelateralapproachversussinustarsiapproachforsanderstypeiiandiiicalcanealfracturesosteosynthesisarandomizedcontrolledtrialof186fractures |