Sinus Tarsi Versus Extensile Lateral Approach For Calcaneal Fractures - A Multicenter Study.

Abstract

The optimal surgical approach for intraarticular calcaneal fractures remains debated. This study compares deep infection rates between the extended lateral (EL) and sinus tarsi (ST) approaches. A retrospective review was conducted of 782 patients treated surgically for OTA 82B/C calcaneal fractures across 15 institutions. Deep infection was defined as requiring surgical débridement or treatment for osteomyelitis. Risk factors were identified using univariate and multivariate analyses. Of 782 fractures, 444 were treated with EL and 338 with ST. Deep infections occurred in 6.8% of EL and 3.0% of ST cases (P = 0.017). Multivariate analysis found that surgical approach (P = 0.03) and age (P < 0.001) were independent risk factors. EL had more wound complications; ST had more symptomatic implants. The ST approach was associated with lower rates of deep infection and wound complications, even in higher-risk patients.