06/03/2021    Leonard A. Levy, DPM, MPH

Efficacy of Calcium Phosphate Cementing in the Surgical Treatment of Sanders Type II and III Calcaneal Fractures Using Screw Fixation with Sinus Tarsi Approach

Calcaneal fractures are the most common fractures
of the tarsal bones and are generally categorized
into intra-articular and extra-articular
fractures. Non-surgical treatment of displaced
intra-articular calcaneal fractures is generally
associated with poor results. Therefore, surgical
treatment is generally recommended for displaced
intra-articular calcaneal fractures.

Open reduction with internal fixation is the most
used technique for displaced intra-articular
calcaneal fractures A study was conducted to
determine the effectiveness of calcium phosphate
cementing (CPC) in the surgical treatment of
Sanders type II and III calcaneal fractures using
screw fixation with sinus tarsi approach. It was
a retrospective study including 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 based on
whether 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 computer
tomography were measured pre-and postoperatively.

Evidence from the study showed 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 a sinus tarsi approach.
Performing this special screw configuration
technique using the sinus tarsi lateral approach
was safe and useful for the operative treatment
of calcaneus fractures. The authors conclude that
this screw technique is a good alternative for
closed, displaced intra-articular calcaneal
fractures, possibly reducing the need for grafts
for calcaneal fractures (Kayali, C, et al. ACTA
ORTHOPAEDICA et TRAUMATOLOGICA TURCICA, 2021;
55(3): 265-70. (DOI: 10.5152/j.aott.2021.20188).

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL

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