Comparison of Calcaneal Exposure Through the Extensile Lateral and Sinus Tarsi Approaches
The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL...
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| Published in: | Foot and ankle specialist Vol. 11; no. 2; pp. 142 - 147 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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01-04-2018
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| Abstract | The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL approaches were performed on cadavers. Calcaneal landmarks were identified by visualization or palpation. Calibrated digital photographs of the posterior facet and lateral calcaneal body were obtained from standardized positions and used to calculate the exposed surface area. No significant difference was found in the average square area of the posterior facet exposed with the 2 approaches. Significantly more of the lateral calcaneal body was seen with the EL approach. Excluding the posterior facet superomedial quadrant, all the landmarks were visualized in 100% of approaches. The superomedial corner was visualized in significantly more of the cadavers with the EL approach and was palpable in 12.5% of the remaining cadavers in both approaches. Whereas the ST approach exposes less of the lateral wall of the calcaneus, it exposes similar amounts of the posterior facet when compared with the EL approach.
Levels of Evidence: Therapeutic, Level V |
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| AbstractList | The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL approaches were performed on cadavers. Calcaneal landmarks were identified by visualization or palpation. Calibrated digital photographs of the posterior facet and lateral calcaneal body were obtained from standardized positions and used to calculate the exposed surface area. No significant difference was found in the average square area of the posterior facet exposed with the 2 approaches. Significantly more of the lateral calcaneal body was seen with the EL approach. Excluding the posterior facet superomedial quadrant, all the landmarks were visualized in 100% of approaches. The superomedial corner was visualized in significantly more of the cadavers with the EL approach and was palpable in 12.5% of the remaining cadavers in both approaches. Whereas the ST approach exposes less of the lateral wall of the calcaneus, it exposes similar amounts of the posterior facet when compared with the EL approach.
Levels of Evidence: Therapeutic, Level V The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL approaches were performed on cadavers. Calcaneal landmarks were identified by visualization or palpation. Calibrated digital photographs of the posterior facet and lateral calcaneal body were obtained from standardized positions and used to calculate the exposed surface area. No significant difference was found in the average square area of the posterior facet exposed with the 2 approaches. Significantly more of the lateral calcaneal body was seen with the EL approach. Excluding the posterior facet superomedial quadrant, all the landmarks were visualized in 100% of approaches. The superomedial corner was visualized in significantly more of the cadavers with the EL approach and was palpable in 12.5% of the remaining cadavers in both approaches. Whereas the ST approach exposes less of the lateral wall of the calcaneus, it exposes similar amounts of the posterior facet when compared with the EL approach.LEVELS OF EVIDENCETherapeutic, Level V. The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL approaches were performed on cadavers. Calcaneal landmarks were identified by visualization or palpation. Calibrated digital photographs of the posterior facet and lateral calcaneal body were obtained from standardized positions and used to calculate the exposed surface area. No significant difference was found in the average square area of the posterior facet exposed with the 2 approaches. Significantly more of the lateral calcaneal body was seen with the EL approach. Excluding the posterior facet superomedial quadrant, all the landmarks were visualized in 100% of approaches. The superomedial corner was visualized in significantly more of the cadavers with the EL approach and was palpable in 12.5% of the remaining cadavers in both approaches. Whereas the ST approach exposes less of the lateral wall of the calcaneus, it exposes similar amounts of the posterior facet when compared with the EL approach. Therapeutic, Level V. |
| Author | Hsu, Joseph R. Blair, James A. Bedigrew, Katherine M. Kirk, Kevin L. Possley, Daniel R. |
| Author_xml | – sequence: 1 givenname: Katherine M. surname: Bedigrew fullname: Bedigrew, Katherine M. organization: Department of Orthopaedics, Carolinas Medical Center, Charlotte, North Carolina (JRH) – sequence: 2 givenname: James A. surname: Blair fullname: Blair, James A. email: jamesablairmd@gmail.com organization: Department of Orthopaedics, Carolinas Medical Center, Charlotte, North Carolina (JRH) – sequence: 3 givenname: Daniel R. surname: Possley fullname: Possley, Daniel R. organization: Department of Orthopaedics, Carolinas Medical Center, Charlotte, North Carolina (JRH) – sequence: 4 givenname: Kevin L. surname: Kirk fullname: Kirk, Kevin L. organization: Department of Orthopaedics, Carolinas Medical Center, Charlotte, North Carolina (JRH) – sequence: 5 givenname: Joseph R. surname: Hsu fullname: Hsu, Joseph R. organization: Department of Orthopaedics, Carolinas Medical Center, Charlotte, North Carolina (JRH) |
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| References | Basile 2010; 49 Ebraheim, Whitehead, Alla 2011; 20 Beltran, Blair, Huh 2013; 44 Zwipp, Tscherne, Thermann, Weber 1993; 290 Weber, Lehmann, Sägesser, Krause 2008; 90 Huh, Krueger, Medvecky 2013; 27 Basile, Albo, Via 2016; 55 Yeo, Cho, Lee 2015; 16 Buckley, Tough, McCormack 2002; 84 Blair, Stinner, Kirby 2010; 24 Wu, Su, Chen 2012; 73 Carr 2005; 19 Sanders, Fortin, DiPasquale, Walling 1993; 290 Hospodar, Guzman, Johnson, Uhl 2008; 31 Holmes 2005; 4 Schepers 2011; 35 Bellamy, Johnson, Beltran 2014; 23 Ebraheim, Ramineni, All 2010; 32 Kline, Anderson, Davis 2013; 34 Scott, Pacholke, Hamid 2016; 37 Kikuchi, Charlton, Thordarson 2013; 34 Radnay, Clare, Sanders 2009; 91 Ebraheim, Elgafy, Sabry, Freih, Abou-Chakra 2000; 21 Sanders 2000; 82 Ding, He, Xiao, Chai, Xue 2013; 34 Benirschke, Sangeorzan 1993 Patzkowski, Kirk, Orr 2012; 33 Benirschke, Kramer 2004; 18 Sanders R (bibr6-1938640017713616) 1993; 290 Zwipp H (bibr7-1938640017713616) 1993; 290 bibr25-1938640017713616 bibr17-1938640017713616 Stover MD. (bibr24-1938640017713616) 2007 Bucholz RWH (bibr1-1938640017713616) 2010 bibr20-1938640017713616 bibr9-1938640017713616 bibr21-1938640017713616 bibr16-1938640017713616 bibr3-1938640017713616 bibr29-1938640017713616 bibr12-1938640017713616 bibr2-1938640017713616 bibr15-1938640017713616 bibr11-1938640017713616 bibr28-1938640017713616 bibr31-1938640017713616 bibr19-1938640017713616 bibr23-1938640017713616 bibr14-1938640017713616 bibr5-1938640017713616 bibr10-1938640017713616 bibr27-1938640017713616 bibr18-1938640017713616 bibr30-1938640017713616 bibr4-1938640017713616 bibr22-1938640017713616 bibr26-1938640017713616 bibr8-1938640017713616 bibr13-1938640017713616 |
| References_xml | – volume: 16 start-page: 63 year: 2015 article-title: Comparison of two surgical approaches for displacement intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach publication-title: BMC Musculoskelet Disord contributor: fullname: Lee – volume: 20 start-page: e13 year: 2011 end-page: e17 article-title: The suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study publication-title: J Shoulder Elbow Surg contributor: fullname: Alla – volume: 37 start-page: 950 year: 2016 end-page: 957 article-title: Radiographic and CT assessment of reduction of calcaneus fractures using a limited sinus tarsi incision publication-title: Foot Ankle Int contributor: fullname: Hamid – volume: 90 start-page: 1608 year: 2008 end-page: 1616 article-title: Limited open reduction and internal fixation of displaced intra-articular fractures of the calcaneum publication-title: J Bone Joint Surg Br contributor: fullname: Krause – volume: 23 start-page: 895 year: 2014 end-page: 901 article-title: Quantification of the exposure of the glenohumeral joint from the minimally invasive to more invasive subscapularis approach to the anterior shoulder: a cadaveric study publication-title: J Shoulder Elbow Surg contributor: fullname: Beltran – start-page: 128 issue: 292 year: 1993 end-page: 134 article-title: Extensive intraarticular fractures of the foot: surgical management of calcaneal fractures publication-title: Clin Orthop Relat Res contributor: fullname: Sangeorzan – volume: 35 start-page: 697 year: 2011 end-page: 703 article-title: The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review publication-title: Int Orthop contributor: fullname: Schepers – volume: 31 start-page: 1112 year: 2008 article-title: Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach publication-title: Orthopedics contributor: fullname: Uhl – volume: 44 start-page: 189 year: 2013 end-page: 193 article-title: Articular exposure with the swashbuckler versus a “Mini-swashbuckler” approach publication-title: Injury contributor: fullname: Huh – volume: 55 start-page: 513 year: 2016 end-page: 521 article-title: Comparison between sinus tarsi approach and extensile lateral approach for treatment of closed displaced intra-articular calcaneal fractures: a multicenter prospective study publication-title: J Foot Ankle Surg contributor: fullname: Via – volume: 290 start-page: 76 year: 1993 end-page: 86 article-title: Osteosynthesis of displaced intraarticular fractures of the calcaneus: results in 123 cases publication-title: Clin Orthop Relat Res contributor: fullname: Weber – volume: 32 start-page: 51 year: 2010 end-page: 54 article-title: Anatomical basis of the vascular risk related to the circumflex scapular artery during posterior approach to the scapula publication-title: Surg Radiol Anat contributor: fullname: All – volume: 34 start-page: 1238 year: 2013 end-page: 1244 article-title: Risk factors for postoperative wound complications of calcaneal fractures following plate fixation publication-title: Foot Ankle Int contributor: fullname: Xue – volume: 34 start-page: 773 year: 2013 end-page: 780 article-title: Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures publication-title: Foot Ankle Int contributor: fullname: Davis – volume: 73 start-page: 743 year: 2012 end-page: 751 article-title: Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts publication-title: J Trauma Acute Care Surg contributor: fullname: Chen – volume: 34 start-page: 1689 year: 2013 end-page: 1694 article-title: Limited sinus tarsi approach for intra-articular calcaneus fractures publication-title: Foot Ankle Int contributor: fullname: Thordarson – volume: 49 start-page: 25 year: 2010 end-page: 32 article-title: Operative versus nonoperative treatment of displaced intra-articular calcaneal fractures in elderly patients publication-title: J Foot Ankle Surg contributor: fullname: Basile – volume: 91 start-page: 541 year: 2009 end-page: 546 article-title: Subtalar fusion after displaced intra-articular calcaneal fractures: does initial operative treatment matter? 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