Comparison of Efficacy Between Tarsal Sinus Minimally Invasive Approach and Extended Lateral Approach in treatment of Intra-Articular Calcaneus Fractures.

Abstract

To compare the clinical efficacy and complication profiles of internal fixation for intra-articular calcaneal fractures via two surgical approaches: the minimally invasive tarsal sinus approach and the extended lateral approach. A retrospective analysis was conducted on 87 single-center patients with calcaneal fractures treated from January 2018 to December 2022. Patients were divided into two groups by surgical approach: 44 cases in the minimally invasive group and 43 in the extended lateral group. Preoperative waiting time, preoperative and 3-month postoperative calcaneal parameters (Böhler angle, Gissane angle, width, height), 12-month postoperative AOFAS ankle-hindfoot score, and early complications (incision infection, flap edge necrosis, etc.) were compared. The minimally invasive group had significantly shorter preoperative waiting time than the extended lateral group (P<0.05). Both groups showed improved calcaneal parameters at 3 months postoperatively (P<0.05), but no significant differences existed between groups in these parameters, AOFAS score, or complication rate (P>0.05). Both approaches effectively restore calcaneal anatomy, improve function, and have comparable complications. However, the minimally invasive approach shortens preoperative waiting time, reducing the economic burden on patients and society.