• Chien-Shun Wang, Yun-Hsuan Tzeng, Tzu-Cheng Yang, Chun-Cheng Lin, Ming-Chau Chang, and Chao-Ching Chiang.
• Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: studpj@gmail.com.
• Injury. 2021 Jul 1; 52 (7): 1971-1977.

BackgroundSinus tarsi approach (STA) is the most commonly used minimally invasive surgery (MIS) in the treatment of displaced intra-articular calcaneal fracture (DIACF). However, there are some limitations related to its limited access. The goal of the present study is to describe a modified 2-incision STA and to evaluate the radiographic and clinical outcomes in the treatment of DIACF.Materials And MethodsPatients had a Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification 82-C, Sanders type II, III calcaneal fracture, and underwent modified 2-incision STA and internal fixation were included in this retrospective study. Serial radiographic measurements and clinical assessment were taken to evaluate the effectiveness of this technique.ResultsThirty-four feet of 33 patients treated between 2014 and 2019 were included with an average follow-up of 28.5 (range, 12-65) months. Mean preoperative Böhler's angle was 1.5 ± 10.0 (range, -26.0-16.9) degrees and mean final Böhler's angle was 29.8 ± 4.9 (range, 19.3-39.3) degrees with significant difference (P < .001). The average American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) pain score at last follow-up were 86.2 ± 5.0 (range, 76-97) and 1.6 ± 1.1 (range, 0-4), respectively. Major complications included 2 (5.9%) wound infections and 1 (2.9%) incomplete separation of the lateral wall prior to plate insertion.Discussion And ConclusionsThis modified 2-incision STA is a safe and effective procedure. It allows access to the posterior facet and posterior calcaneal tuberosity, appropriate restoration of blowout lateral wall, and easy placement of a standard calcaneal plate.Copyright © 2021 Elsevier Ltd. All rights reserved.

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