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Plate fixation through the lateral extensile approach versus cannulated screw fixation through the sinus tarsi approach for calcaneal fracture: a multicenter, propensity score-matched TRON study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

For calcaneal fracture, plate fixation through lateral extensive approach (LEP) is the most common procedure performed to achieve anatomic reduction. However, wound complications sometimes occur after LEP. To reduce complications, minimally invasive operative methods with cannulated screw fixation through sinus tarsi approach (STS) were developed. The aim of this multicenter propensity-matched study was to compare the clinical and radiographic outcomes of LEP to those of STS for calcaneal fracture and to evaluate the incidence of postoperative complications including surgical site infection (SSI).

Methods

We extracted 271 patients with calcaneal fracture undergoing surgery between January 2014 and March 2019 from our multicenter TRON database. We assessed the American Orthopedic Foot and Ankle Society (AOFAS) score at the final follow-up as the clinical outcome. We obtained the Bohler and Preis angles as radiographic parameters and also recorded the complications. We divided the subjects into two groups: LEP group and STS group. To adjust for baseline differences between the groups, a propensity score matching algorithm was used in a 1:1 ratio.

Results

After matching, there were 32 fractures in each group. There was no significant difference between the LEP versus STS group in AOFAS score at final follow-up (90 vs 90 points, p = 0.98) and in the Bohler and Pries angles (19.2 vs. 18.0 degrees, p = 0.74 and 16.0 vs. 17.5 degrees, p = 0.47). The rate of SSI in the LEP group was higher than that in the STS group (21.9% vs. 0.0%, p = 0.01).

Conclusion

For calcaneal fracture, STS provides similar fixation effectiveness and functional outcomes as LEP while reducing the likelihood of infection.

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Data are available on request from the authors.

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Acknowledgements

We thank Tokumi Kanemura, Masahiro Hanabayashi, Osamu Ito, Yasuhide Kanayama, Koji Maruyama, Hiroaki Yoshida and Toshihiro Ando for data collection.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Takuya Sugimoto, Yasuhiko Takegami, Ryosuke Sugimoto, Yujiro Kagami & Shiro Imagama

  2. Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya, Aichi, 466-8550, Japan

    Katsuhiro Tokutake

  3. Department of Orthopedic Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Nobuyuki Okui

  4. Department of Orthopedic Surgery, Toyota Kosei Hospital, Toyota, Japan

    Yasuhide Kanayama

  5. Department of Orthopedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    Hidenori Inoue

Authors
  1. Takuya Sugimoto
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  2. Katsuhiro Tokutake
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  3. Yasuhiko Takegami
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  4. Nobuyuki Okui
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  5. Yasuhide Kanayama
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  6. Hidenori Inoue
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  7. Ryosuke Sugimoto
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  8. Yujiro Kagami
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  9. Shiro Imagama
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Contributions

YT and KT had contributed to conceptualization. TS, YK and RS were involved in methodology, formal analysis and investigation. TS took part in the original draft preparation. YT carried out writing, reviewing and editing. NO, YK, HI, TK, MH, OI, YK, KM, HY and TA assisted with resources. SI performed supervision.

Corresponding author

Correspondence to Katsuhiro Tokutake.

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Ethical approval

The approval number from our institution is 2020–0550.

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Sugimoto, T., Tokutake, K., Takegami, Y. et al. Plate fixation through the lateral extensile approach versus cannulated screw fixation through the sinus tarsi approach for calcaneal fracture: a multicenter, propensity score-matched TRON study. Eur J Orthop Surg Traumatol 32, 1333–1340 (2022). https://doi.org/10.1007/s00590-021-03115-9

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  • DOI: https://doi.org/10.1007/s00590-021-03115-9

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