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Comparing less invasive plate fixation versus screw fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

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Abstract

Purpose

The purpose of this study was to compare the post-operative radiographic and clinical outcomes of less invasive plate fixation versus screw fixation of displaced intra-articular calcaneus fractures (DIACFs) via sinus tarsi approach.

Methods

A total of 165 consecutive DIACFs that underwent open reduction internal fixation via sinus tarsi approach from 2013 to 2018 were reviewed at least a two year follow-up. The methods of fixation were divided into two groups: less invasive plate fixation versus screw fixation of calcaneus fracture (59 vs 106, respectively). The radiographic outcomes including pre- and post-operative Bohler’s and Gissane’s angles were evaluated. The post-operative function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, the Olerud and Molander Scale and the Visual Analogue Scale (VAS). The complications, the rates of implant removal and cost were also compared.

Results

The average follow-up was 44.2 months in the plate groups and 47.9 months in the screw groups (P > 0.05). There was no significant difference in the Bohler’s angle and Gissane’s angle between the plate group and screw group during the pre-operation and the last follow-up. There was no significant difference in the final AOFAS score, Olerud and Molander score and VAS score between the two groups (P > 0.05). The total incidence of complications was 6.7% in the plate group and 6.6% in the screw group (P > 0.05). The rates of implant removal and total cost during the hospitalization in the plate group were significantly higher compared with screws group (P < 0.05).

Conclusion

The less invasive plate fixation versus screw fixation of DIACFs via sinus tarsi approach contributed comparable quality of reduction, complications and post-operative functional outcomes. The less invasive plate technique was significantly higher in terms of implant costs and the rate of implant removal.

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Acknowledgements

The authors gratefully thank those surgeons and patients who made this study possible.

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Author notes

  1. Changjun Guo and Yangbo Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Changjun Guo, Chunguang Li, Xingchen Li, Ming Cai & Xiangyang Xu

  2. Department of Orthopaedics, Rui Jin North Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Changjun Guo, Chunguang Li, Xingchen Li, Ming Cai & Xiangyang Xu

  3. Department of Bone and Joint Surgery, Hospital of Southwest Medical University, Luzhou, China

    Yangbo Xu

  4. Department of Orthopaedics, Zhangjiagang Fifth People’s Hospital, Zhangjiagang, China

    Zhengxiang Wang

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  1. Changjun Guo
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  4. Xingchen Li
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Correspondence to Ming Cai or Xiangyang Xu.

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The manuscript submitted does not contain information about medical device(s)/drug(s).

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The authors declare that they have no conflict of interest.

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Our study was approved by the Ruijin North Hospital Ethics Committee, Shanghai JiaoTong University School of Medicine. Written consent was provided by participants to be included in the study. Written informed consent for publication was obtained from all participants.

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Guo, C., Xu, Y., Li, C. et al. Comparing less invasive plate fixation versus screw fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach. International Orthopaedics (SICOT) 45, 2231–2237 (2021). https://doi.org/10.1007/s00264-020-04867-5

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  • DOI: https://doi.org/10.1007/s00264-020-04867-5

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