Minimally Invasive Sinus Tarsi Approach With Cannulated Screw Fixation Combined With Vacuum-Assisted Closure for Treatment of Severe Open Calcaneal Fractures With Medial Wounds

• Published in: The Journal of foot and ankle surgery Vol. 55; no. 1; pp. 112 - 116
• Main Authors: Zhang, Taiyuan, MD, Yan, Yan, MS, Xie, Xinmin, BS, Mu, Weidong, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2016
• Subjects: Adult; Ankle Injuries - diagnostic imaging; Ankle Injuries - therapy; Bone Plates; Bone Screws; Böhler's angle; calcaneus; Calcaneus - diagnostic imaging; Calcaneus - injuries; Calcaneus - surgery; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Fractures, Open - diagnostic imaging; Fractures, Open - therapy; Humans; injury; Intra-Articular Fractures - diagnostic imaging; Intra-Articular Fractures - therapy; length of stay; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; negative pressure; Negative-Pressure Wound Therapy - methods; open fracture; Orthopedics; Prospective Studies; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; 4; calcaneus; open fracture; negative pressure; length of stay; Böhler's angle; injury
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2015.07.023

Abstract 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). The Böhler and Gissane angles were compared before and after surgery. The clinical results were evaluated using according to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale and the rate of infection. The follow-up duration for all patients ranged from 10 to 36 (mean 24) months. No statistically significant differences were found in the radiologic indicators, incidence of early postoperative complications, or American Orthopaedic Foot and Ankle Society ankle-hindfoot scores ( p  > .05) between the 2 groups. However, a statistically significant difference was seen in the duration of hospitalization ( p  < .05) between the 2 groups. A minimally invasive sinus tarsi approach with cannulated screw fixation combined with vacuum-assisted closure is an effective method for the treatment of severe open calcaneal fractures with medial wounds. It provides good reduction and requires fewer days of hospitalization.