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. 2021 May;55(3):265-270.
doi: 10.5152/j.aott.2021.20188.

Efficacy of calcium phosphate cementing in the surgical treatment of Sanders Type II and III calcaneal fractures using screw fixation with sinus tarsi approach

Cemil Kayalı  1 , Fırat Ozan  2 , Taşkın Altay  1 , Hüseyin Gökhan Karahan  1 , Kamil Yamak  1 , Soner Özdemir  1
Affiliations

Efficacy of calcium phosphate cementing in the surgical treatment of Sanders Type II and III calcaneal fractures using screw fixation with sinus tarsi approach

Cemil Kayalı et al. Acta Orthop Traumatol Turc. 2021 May.

Abstract

Objective: This study aimed to determine the effectiveness of calcium phosphate cementing in the surgical treatment of Sanders type II and III calcaneal fractures using screw fixation with sinus tarsi approach.

Methods: In this retrospective study, 85 feet of 84 patients (74 males, 10 females; mean age 43 [17-61] years) in whom screw fixation was performed using the sinus tarsi approach for Sanders type II or III calcaneal fractures were included. The mean follow-up was 28 (14-39) months. Patients were categorized into 2 groups on the basis of whether calcium phosphate cement (CPC) was used. Group 1 had 37 patients with CPC (38 calcaneal fractures) and group 2 had 47 patients without CPC (47 calcaneal fractures). In the clinical assessment, the American Orthopedic Foot Ankle Society (AOFAS) hind foot score and the Maryland Foot Score (MFS) were used at the final follow-up. In the radiological assessment, Bohler's angle on plain radiograph and posterior facet step-off on computed tomography were measured pre-and postoperatively.

Results: At the final follow-up, the mean Bohler's angle was 26.2° (20°-33°) in group 1 and 26° (17°-30°) in group 2 (P = 0.85). The mean posterior facet step-off was 1.6 (0-5) mm in group 1 and 1.5 (0-5) mm in group 2 (P = 0.85). The mean AOFAS score was 83.8 (59-100) in group 1 and 85.8 (60-100) in group 2 (P = 0.5). The mean MFS was 86.3 (66-100) in group 1 and 87.7 (66-100) in group 2 (P = 0.62).

Conclusion: Evidence from this study have shown that CPC may have no significant effect on clinical and radiological outcomes in the surgical treatment of Sanders type II and III calcaneal fractures using screw fixation with sinus tarsi approach.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1. a–c
Figure 1. a–c
(a) Preoperative lateral radiograph showing the right calcaneal fracture in an 18-year-old male patient. (b, c) Coronal and sagittal sections of the computed tomography image showing the incongruity of the articular sur face
Figure 2. a, b
Figure 2. a, b
(a) Skin incision extending from the tip of the lateral malleolus toward the base of the fourth metatarsal bone. (b) The peroneal tendons are retracted, the extensor digitorum brevis dissected, and the subtalar joint surface exposed
Figure 3. a–c
Figure 3. a–c
(a) The joint is restored by elevating and derotating the displaced facet fragments, which were temporarily fixed with a Kirschner wire. (b) Reduced posterior facet is fixed to the sustentaculumtali with a 3.5-mm cortical scre w. (c) Subsequently, a satisfactory reduction is obtained under C-arm fluoroscopy
Figure 4. a, b
Figure 4. a, b
(a) A total of 2 6.5-mm cancellous cannulated screws are placed into the calcaneus converging toward the distal calcaneus. (b) The incision is closed
Figure 5
Figure 5
Radiography performed 21 months postoperatively
See this image and copyright information in PMC

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