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Sinus tarsi approach

Michael P Swords, Phillip Penny
The treatment of calcaneus fractures is controversial. Historically, most operatively treated fractures have been approached with a lateral extensile incision requiring delay in operative treatment until swelling has improved. There is a current trend and interest in small incision approaches allowing, and in some cases requiring, earlier operative fixation. Clinical scenarios amenable to consideration for early fixation are reviewed. The sinus tarsi surgical approach and reduction techniques are outlined in detail...
March 2017: Foot and Ankle Clinics
R Carter Clement, Pamela J Lang, Brett J Pettett, Robert A Overman, Robert F Ostrum, Josh N Tennant
OBJECTIVE: This study compares the cost and cost-effectiveness of treatments options for Sanders II/III displaced intra-articular calcaneus fractures (DIACF's) in laborers. METHODS: Literature on Sanders type II and III fractures was reviewed to determine complication rates and utility values for each treatment option. Costs were calculated using Medicare reimbursement and implant prices from our institution. Monte Carlo simulations were used to analyze a decision-tree to determine the cost and cost-effectiveness of each treatment from a societal perspective...
January 30, 2017: Journal of Orthopaedic Trauma
Fei Zhang, Hongtao Tian, Shilun Li, Bo Liu, Tianhua Dong, Yanbin Zhu, Yingze Zhang
BACKGROUND: There remains a controversy between extensile lateral approach and sinus tarsi approach (STA) to treat calcaneal fractures. The aim of this study is to evaluate the medium- and long-term outcomes of the STA versus extensile lateral approach in terms of intraoperative variables, quality of alignment on a lateral radiograph incidence of wound healing complication, visual analogue scale and American Orthopaedic Foot and Ankle Society for the treatment of calcaneal fractures. METHODS: Relevant original studies were searched in PubMed, Medline and Embase and Chinese National Knowledge Infrastructure (January 1990 and November 2015)...
January 25, 2017: ANZ Journal of Surgery
Zhe Wang, Xiu Hui Wang, Sheng Long Li, Xin Tang, Bei Gang Fu, Ming Hui Wang, Sheng Li Xia
BACKGROUND: According to the anatomic characteristics of the calcaneus and the sinus tarsi approach, we designed a combined plate. The goal of this study was to retrospectively assess the functional outcomes and complications of treatment with our self-designed plate. METHODS: From March 2014 to October 2015, 18 patients with closed calcaneal fractures (14 Sanders type II and 4 type III) were treated with our combined locking plate through a minimally invasive sinus tarsi approach...
December 23, 2016: Journal of Orthopaedic Surgery and Research
Emmanuel D Eisenstein, Mario Rodriguez, Amr A Abdelgawad
Introduction. Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail. Methods. We proposed development of an intramedullary device for ankle arthrodesis which spared the subtalar joint using a sinus tarsi approach. Standard saw bones models and computer assisted modeling and stress analysis were used to develop different nail design geometries and determine the feasibility of insertion. After the final design was constructed, the device was tested on three cadaveric specimens...
2016: Advances in Orthopedics
Andrija Jurina, Damjan Dimnjaković, Tomislav Smoljanović, Ivan Bojanić
: Intra-articular calcaneal osteoid osteoma is a very rare condition and the diagnosis as well as the treatment is extremely challenging. We report a case of a 19-year-old male with intra-articular osteoid osteoma of the calcaneus, initially treated for peroneal tenosynovitis with unsatisfactory results. Thorough diagnostic procedure revealed the superolateral location of a calcaneal osteoid osteoma, near the sinus tarsi. A cherry-red elevated lesion typical of an osteoid osteoma nidus was completely removed arthroscopically using the anterolateral portal and the middle portal for subtalar arthroscopy...
November 4, 2016: Foot & Ankle Specialist
Lian-Hua Li, Yong-Zhi Guo, Hao Wang, Qing-Hua Sang, Jian-Zheng Zhang, Zhi Liu, Tian-Sheng Sun
BACKGROUND: We conducted a prospective randomized clinical trial to compare the clinical and radiological outcomes of the sinus tarsi and extended lateral approaches for the surgical treatment of displaced intraarticular calcaneal fractures. METHODS: Between January 2009 and January 2014, patients with displaced intraarticular calcaneal fracture were randomly assigned to receive surgical treatment by the sinus tarsi approach or the extended lateral approach using block randomization...
September 2016: Medicine (Baltimore)
Richard Walter, Stephen Parsons, Ian Winson
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported.
September 2016: Foot and Ankle Clinics
Yongzeng Feng, Xiaolong Shui, Jianshun Wang, Leyi Cai, Yang Yu, Xiaozhou Ying, Jianzhong Kong, Jianjun Hong
BACKGROUND: The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective randomized controlled trial was conducted to compare percutaneous reduction, cannulated screw fixation and calcium sulfate cement (PR+CSC) grafting with minimally invasive sinus tarsi approach and plate fixation (MISTA) for treatment of DIACFs. METHODS: Ultimately, 80 patients with a DIACFs were randomly allocated to receive either PR+CSC (N = 42) or MISTA (N = 38)...
2016: BMC Musculoskeletal Disorders
Aaron T Scott, David A Pacholke, Kamran S Hamid
BACKGROUND: The lateral extensile incision for fixation of displaced intra-articular calcaneus fractures allows for fracture reduction but has been associated with high rates of soft tissue complications. This has prompted a search for less invasive methods of fracture fixation. The purpose of the present study was to determine the adequacy of reduction and rate of complications associated with operative fixation of calcaneal fractures using a limited sinus tarsi approach. METHODS: A limited sinus tarsi incision with plate fixation was utilized for treatment of 39 displaced intra-articular calcaneal fractures in 35 consecutive patients as part of a single surgeon series...
September 2016: Foot & Ankle International
M Pompach, M Carda, M Amlang, H Zwipp
OBJECTIVE: Anatomic reconstruction of the posterior facet by primary stabilization of the calcaneal fracture with a locking nail. INDICATIONS: All intraarticular calcaneal fractures and unstable two-part fractures independent of the degree of closed/open soft tissue trauma. CONTRAINDICATIONS: High perioperative risk, soft tissue infection, beak fracture (type II fracture) and still open apophysis. SURGICAL TECHNIQUE: Anatomic reduction of the posterior facet using a sinus tarsi approach...
June 2016: Operative Orthopädie und Traumatologie
Marcos Emilio Kuschnaroff Contreras, Luciano Manoel Kroth, Keith Lúcia Kotani, Jorge Luiz Da Silva Junior, Mário Cesar De Andrade, Aluísio Otávio Vargas Ávila, Francisco José Berral
OBJECTIVE: Verify the variables of plantar pressure distribution of patients submitted to surgical procedure for calcaneal fracture, and correlate them with two different surgical approaches. METHOD: The authors studied 15 patients between 20 and 53 years of age (average 40.06 yrs.) who had intra-joint calcaneal fractures, submitted to surgical treatment by means of two different approaches: the lateral and the sinus tarsi. The authors checked the plantar pressure distribution by correlating these variables with the two different surgical approaches...
January 2009: Revista Brasileira de Ortopedia
S Rammelt, M Amlang, A K Sands, M Swords
The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously...
March 2016: Der Unfallchirurg
Hans Zwipp, Libor Paša, Luboš Žilka, Michael Amlang, Stefan Rammelt, Martin Pompach
OBJECTIVES: To reduce the complication rate associated with open reduction and internal fixation of displaced intraarticular calcaneal fractures through extensile approaches, a locking nail system (C-Nail) was developed for internal fixation. DESIGN: Prospective case-control study. SETTING: Two level I trauma centers (university hospital) and 1 large regional hospital in the Czech Republic and Germany. PATIENTS: One hundred three patients (89 male and 14 female; mean age, 45...
March 2016: Journal of Orthopaedic Trauma
R A Fuhrmann, T Pillukat
OBJECTIVE: Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. INDICATIONS: Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. CONTRAINDICATIONS: Inflammation, vascular disturbances, nicotine abuse. SURGICAL TECHNIQUE: Approach dependent on assessment. Lateral approach: Supine position...
June 2016: Operative Orthopädie und Traumatologie
Attilio Basile, Francesco Albo, Alessio Giai Via
The purpose of our investigation was to prospectively review and compare the early outcomes of Sanders II and III closed displaced intra-articular calcaneal fractures (DIACFs) in a group of patients treated by open reduction and internal fixation with plate and screws using the extended lateral approach or the sinus tarsi approach (STA). Thirty-eight patients with DIACFs were prospectively enrolled and operatively treated using either the extended lateral approach or the STA. Patients underwent a careful clinical and radiographic examination and were evaluated according to the American Orthopaedic Foot and Ankle Society score, visual analog scale, and the Foot Function Index...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Brian M Farrell, Carol A Lin, Charles N Moon
INTRODUCTION: Surgical management of calcaneus fractures is technically demanding and has a high risk of wound complications. These fractures are traditionally managed with splinting until swelling has subsided, which can take weeks and leaves the fracture fragments displaced. We describe a novel protocol for the management of displaced intraarticular calcaneus fractures that utilises a temporising external fixator and staged conversion to plate fixation through a sinus tarsi approach...
September 2015: Injury
Taiyuan Zhang, Yan Yan, Xinmin Xie, Weidong Mu
The aim of our prospective study was to investigate the clinical results and advantages of a minimally invasive sinus tarsi approach with cannulated screw fixation combined with vacuum-assisted closure for the treatment of severe open calcaneal fractures with medial wounds. A total of 31 patients (32 feet) with open calcaneal fractures who were admitted to our hospital from January 2008 to May 2013 were selected for the study and randomly divided into 2 groups: the cannulated screw group (n = 16 patients, 16 feet) and the plate group (n = 15 patients, 16 feet)...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Marek Napiontek, Tomasz Jaszczak
BACKGROUND: The aim of the study was to analyze the results of treatment by ankle arthrodesis by modified Mann's technique. METHODS: The study included 23 patients, and a total of 23 feet were treated. Stabilization of arthrodesis was performed by two screws going from the sinus tarsi to the talus and tibia. Lateral part of the fibula was fixed with one or two screws to the talus and tibia. No additional medial approach to the ankle was performed. In 16 feet, arthrodesis was done due to secondary posttraumatic osteoarthritis, in five due to paralytic drop foot and in two due to osteoarthritis of unknown etiology...
October 2015: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Andrew R Hsu, Robert B Anderson, Bruce E Cohen
Intra-articular calcaneus fractures are commonly sustained after high-energy trauma, and a variety of techniques exists for anatomic reduction and surgical fixation. Traditional approaches using an extended L-shaped lateral incision with lateral plating for open reduction and internal fixation have relatively high complication rates. Common complications include hematoma formation, skin edge necrosis, wound breakdown, and superficial or deep infection. As a result, less invasive techniques have been developed in recent years, including limited-incision sinus tarsi open reduction and internal fixation, percutaneous fixation, and arthroscopic-assisted fixation...
July 2015: Journal of the American Academy of Orthopaedic Surgeons
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