{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:00:14Z","timestamp":1791140414369,"version":"4.1.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To evaluate the difference in the quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative Computed Tomography (CT) scans in displaced intra-articular calcaneal fractures (DIACFs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level 1 and level 2 academic centers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Consecutive patients undergoing operative fixation of DIACFs with postoperative CT scans and standard radiographs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients were identified based on Current Procedural Terminology code and chart review. All operative calcaneal fractures treated between 2012 and 2018 by fellowship-trained orthopaedic trauma surgeons were evaluated. Those with both postoperative CT scans and radiographs were included. Exclusion criteria included extra-articular fractures, malunions, percutaneous fixation, ORIF and primary fusion, and those patients without a postoperative CT scan. The Sanders classification was used. Cases were divided into 2 groups based on ELA versus STA. Bohler angle and Gissane angle were evaluated on plain radiographs. CT reduction quality grading included articular step off\/gap within the posterior facet, and varus angulation of the tuberosity: CT reduction grading included: excellent (E): no gap, no step, and no angulation; good (G): &lt;1 mm step, &lt;5 mm gap, and\/or &lt;5\u00b0 of angulation, fair (F): 1\u20133 mm step, 5\u201310 mm gap, and\/or 5\u201315\u00b0 angulation; and poor (P): &gt;3 mm step, &gt;10 mm gap, and\/or &gt;15\u00b0 angulation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Seventy-seven patients with 83 fractures were included. Average age was 42 years (range, 18\u201374 years), with 57 men. Four fractures were open. There were 37 Sanders II and 46 Sanders III fractures; 36 fractures were fixed using the STA, whereas 47 used the ELA. Average days to surgery were 5 for STA and 14 for ELA (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). A normal Bohler angle was achieved more often with the ELA (91.5%) than with STA (77.8%) (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). There was no difference by approach for Gissane angle (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.5). ELA had better overall reduction quality (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02). For Sanders II, there was no difference in reduction quality with STA versus ELA (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.51). For Sanders III, ELA trended toward better reduction quality (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.06).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The ELA had a better overall reduction of Bohler angle on plain radiographs and of the posterior facet and tuberosity on postoperative CT scans. For Sanders type II DIACFs, there was no difference between STA and ELA. Importantly, for Sanders III DIACFs, ELA trended toward better reduction quality. In addition to fracture reduction, surgeon learning curve, early wound complications, and long-term outcomes must be considered in future studies comparing the ELA and STA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001971","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T20:05:30Z","timestamp":1601064330000},"page":"285-288","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":31,"title":["Quality of Reduction of Displaced Intra-articular Calcaneal Fractures Using a Sinus Tarsi Versus Extensile Lateral Approach"],"prefix":"10.1097","volume":"35","author":[{"given":"Gennadiy","family":"Busel","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Health Partners, Department of Orthopaedic Surgery, Abbott Northwestern Hospital, Minneapolis, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan R.","family":"Mir","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Merimee","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raahil","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Morsani College of Medicine, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Atassi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"De La Fuente","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic Specialty Associates, Fort Worth, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Donohue","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Maxson","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Infante","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjan","family":"Shah","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Watson","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katheryne","family":"Downes","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy W.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Florida Orthopaedic Institute, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/00003086-199305000-00012","article-title":"Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification","volume":"290","author":"Sanders","year":"1993","journal-title":"Clin Orthop Relat Res."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.2106\/00004623-200210000-00001","article-title":"Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial","volume":"84","author":"Buckley","year":"2002","journal-title":"J Bone Joint Surg Am."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/00003086-199305000-00009","article-title":"Open treatment of acute calcaneal fractures","volume":"290","author":"Letournel","year":"1993","journal-title":"Clin Orthop Relat Res."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/00003086-199307000-00015","article-title":"Extensive intraarticular fractures of the foot. Surgical management of calcaneal fractures","volume":"292","author":"Benirschke","year":"1993","journal-title":"Clin Orthop Relat Res."},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/00005373-198804000-00016","article-title":"Operative treatment of displaced intra-articular fractures of the calcaneus","volume":"28","author":"Sclamberg","year":"1988","journal-title":"J Trauma."},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ijsu.2017.12.034","article-title":"Minimally invasive versus extensile lateral approach for Sanders type II and III calcaneal fractures: a meta-analysis of randomized controlled trials","volume":"50","author":"Zeng","year":"2018","journal-title":"Int J Surg."},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.otsr.2017.12.015","article-title":"Sinus tarsi approach (STA) versus extensile lateral approach for treatment of closed, displaced intra-articular calcaneal fractures (DIACF): a meta-analysis","volume":"104","author":"Bai","year":"2018","journal-title":"Orthop Traumatol Surg Res."},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/BOT.0000000000000169","article-title":"Operative treatment of displaced intra-articular calcaneal fractures: a long-term (10-20 Years) results in 108 fractures using a prognostic CT classification","volume":"28","author":"Sanders","year":"2014","journal-title":"J Orthop Trauma."},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"925","DOI":"10.3113\/FAI.2012.0925","article-title":"Mini-open sinus tarsi approach with percutaneous screw fixation of displaced calcaneal fractures: a prospective computed tomography\u2013based study","volume":"33","author":"Nosewicz","year":"2012","journal-title":"Foot Ankle Int."},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13018-017-0511-5","article-title":"Minimally invasive percutaneous osteosynthesis versus ORIF for Sanders type II and III calcaneal fractures: a prospective, randomized intervention trial","volume":"12","author":"Jin","year":"2017","journal-title":"J Orthop Surg Res."},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1186\/s13018-018-0943-6","article-title":"Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis","volume":"13","author":"Mehta","year":"2018","journal-title":"J Orthop Surg Res."},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1053\/j.jfas.2015.11.008","article-title":"Comparison between sinus tarsi approach and extensile lateral approach for treatment of closed displaced intra-articular calcaneal fractures: a multicenter prospective study","volume":"55","author":"Basile","year":"2016","journal-title":"J Foot Ankle Surg."},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1177\/1071100713477607","article-title":"Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures","volume":"34","author":"Kline","year":"2013","journal-title":"Foot Ankle Int."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001971","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T19:03:11Z","timestamp":1749927791000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000001971","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"2020-09-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}