Randomized comparative study between extensile lateral and sinus tarsi approaches for the treatment of Sanders type 2 calcaneal fracture

研究概要

Sixty-four patients with Type 2A and 2B calcaneal fractures were randomized to receive surgical treatment using the extensile lateral approach (ELA) (n=32) or the sinus tarsi approach (SAT) (n=32). The primary outcome of interest was the incidence of wound complications including minor (i.e. superficial infection, superficial marginal wound necrosis) and major (deep infection, deep marginal wound necrosis). Secondary outcomes of interest were incidence of sural nerve injury, incidence of checkrein deformity, pain using the Visual Analogue Scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, quality of life measured using the Short Form health survey (SF-36), length of surgery, range of motion of the subtalar joint, radiological outcomes (i.e. Böhler’s angle and calcaneal width), and the incidence of posterior facet reduction. Both VAS pain and AOFAS were evaluated at both 6-months and 12-months post-treatment while SF-36 was only evaluated at 12 months follow-up. Results of this randomized controlled trial revealed that mean VAS and mean AOFAS scores (p=0.017, p=0.021, respectively) were statistically significantly improved at 6-months, but this did not last until 12-months (p>0.05). Moreover, subtalar joint range of motion was statistically significantly higher in the STA group vs ELA group (p=0.015). Mean surgical time was statistically significantly reduced in the STA group vs ELA group (p<0.001). The mean calcaneal width was statistically significantly higher in the STA group (p=0.002) where the difference between the injured and uninjured side at 12-months follow-up was statistically significantly different (p<0.001). All other outcomes were not statistically significantly different between the 2 groups(p>0.05).