Limited sinus tarsi approach for treatment of intraarticular fractures of the calcaneus

Purpose: Is limited sinus tarsi approach sufficient to reduce and fix intraarticular fracture calcaneus? What type of fracture can be treated through this approach and added techniques to facilitate reduction and fixation? Methods: Thirty feet in 28 patients with intraarticular fracture calcaneus were treated using limited sinus tarsi approach with added percutaneous reduction and fixation. Plain X-Ray films included anteroposterior (AP) view; lateral view, axial heel view, and Broden’s oblique view of the foot were done for all patients. Preoperative computed tomographic (CT) examination was done for all patients. The classification of fractures according to Sander’s et al was type II in 10 feet, type III in 20 feet. Results: Eight patients (28.5%) had no pain; sixteen patients (57%) had mild tolerable pain with activity, and four (14.5%) patients had moderate pain needing anti-inflammatory and analgesics. According to the American Orthopedic Foot and Ankle Society (AOFAS) score, eight patients had excellent score (28.6%), good in ten (35.7%), fair in six (21.4%) and poor in four (14.3%). Conclusion: The limited lateral sinus tarsi approach gives good reduction aided by percutaneous reduction and screw fixation. The technique is more effective in patients with type II & III Sander’s classification especially in risky patients. The timing of operation can be as soon as possible with reduced rate of soft tissue morbidity and good range of motion compared with the extensile formal procedures.