{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:15:34Z","timestamp":1785453334114,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,10,2]],"date-time":"2021-10-02T00:00:00Z","timestamp":1633132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002560","name":"Soonchunhyang University","doi-asserted-by":"publisher","award":["1021-0001"],"award-info":[{"award-number":["1021-0001"]}],"id":[{"id":"10.13039\/501100002560","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Although various outcomes of the sinus tarsi approach have been reported, these are limited to the Sanders type 2 displaced intraarticular calcaneal fractures (DIACF) because of the limited visibility of the posterior facet joint. In this study we aimed to (1) introduce a sinus tarsi approach combined with an anterolateral fragment open-door technique that enables adequate visibility of the innermost and middle portion of the posterior facet joint, and (2) evaluate the radiographic and clinical outcomes of the patients treated with that technique. This is a retrospective case-series study performed on medical records of 25 patients who presented with the Sanders type 3 or 4 DIACF and were treated with the sinus tarsi approach. The radiologic measurements showed significant corrections of the Bohler\u2019s angle, calcaneal width, length, height, and articular step-off in both X-rays and CTs in the last follow-up period. The mean AOFAS score was 90.08 \u00b1 6.44 at the last follow-up. Among all the follow-up patients, two cases (8%) had acute superficial infections, and no other wound complications occurred. Therefore, we suggest that the Sanders type 3 or 4 DIACF could be successfully treated with the proposed technique with low complications and bring out effective clinical and radiologic outcomes.<\/jats:p>","DOI":"10.3390\/ijerph181910400","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T09:24:15Z","timestamp":1633339455000},"page":"10400","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-4680","authenticated-orcid":false,"given":"Jaeho","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, 77, Sakju-ro, Gyo-dong, Chuncheon 24262, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9661-8478","authenticated-orcid":false,"given":"Jahyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Myeong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Seok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Hong","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5471-7432","authenticated-orcid":false,"given":"Sung Hun","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-4251","authenticated-orcid":false,"given":"Young","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Seoul Foot and Ankle Center, Inje University Seoul Paik Hospital, 85, 2-ga, Jeo-dong, Jung-gu, Seoul 04551, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-8984","authenticated-orcid":false,"given":"Dong-il","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,2]]},"reference":[{"key":"ref_1","first-page":"395","article-title":"The mechanism, reduction technique, and results in fractures of the os calcis","volume":"39","year":"1952","journal-title":"Br. J. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0020-1383(01)00024-9","article-title":"The operative management of displaced intra-articular fractures of the calcaneum: A two-centre study using a defined protocol","volume":"32","author":"Tennent","year":"2001","journal-title":"Injury"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1177\/107110079801901211","article-title":"Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures","volume":"19","author":"Abidi","year":"1998","journal-title":"Foot Ankle Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00003086-200110000-00003","article-title":"Complications of intraarticular calcaneal fractures","volume":"391","author":"Lim","year":"2001","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/TA.0b013e318253b5f1","article-title":"Functional outcome of displaced intra-articular calcaneal fractures: A comparison between open reduction\/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts","volume":"73","author":"Wu","year":"2012","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Yeo, J.-H., Cho, H.-J., and Lee, K.-B. (2015). Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: Sinus tarsi versus extensile lateral approach. BMC Musculoskelet. Disord., 16.","DOI":"10.1186\/s12891-015-0519-0"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1302\/0301-620X.90B12.20638","article-title":"Limited open reduction and internal fixation of displaced intra-articular fractures of the calcaneum","volume":"90","author":"Weber","year":"2008","journal-title":"J. Bone Jt. Surgery. Br. Vol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/01.btf.0000156336.58175.e1","article-title":"Treatment of displaced calcaneal fractures using a small sinus tarsi approach","volume":"4","author":"Holmes","year":"2005","journal-title":"Tech Foot Ankle Surg"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11751-010-0084-x","article-title":"Subtalar versus triple arthrodesis after intra-articular calcaneal fractures","volume":"5","author":"Schepers","year":"2010","journal-title":"Strateg. Trauma Limb Reconstr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1177\/107110070502600802","article-title":"\u201cSmile\u201d incision: An approach for open reduction and internal fixation of calcaneal fractures","volume":"26","author":"Wiley","year":"2005","journal-title":"Foot Ankle Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2106\/00004623-194830010-00002","article-title":"The mechanism and treatment of fractures of the calcaneus; open reduction with the use of cancellous grafts","volume":"30","author":"Palmer","year":"1948","journal-title":"J. Bone Jt. Surgery. Am. Vol."},{"key":"ref_12","first-page":"322","article-title":"Minimally invasive sinus tarsi approach in Sanders II-III calcaneal fractures in high-demand patients","volume":"18","author":"Ceccarini","year":"2021","journal-title":"Med. Glas.: Off. Publ. Med Assoc. Zenica-Doboj Canton Bosnia Herzeg"},{"key":"ref_13","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":"ref_14","first-page":"1112","article-title":"Treatment of displaced calcaneus fractures using a minimally invasive sinus tarsi approach","volume":"31","author":"Hospodar","year":"2008","journal-title":"Orthopedics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/BOT.0000000000000169","article-title":"Operative treatment of displaced intraarticular calcaneal fractures: 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":"ref_16","doi-asserted-by":"crossref","first-page":"e17611","DOI":"10.1097\/MD.0000000000017611","article-title":"Can sural nerve injury be avoided in the sinus tarsi approach for calcaneal fracture: A cadaveric study","volume":"98","author":"Park","year":"2019","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00256-007-0330-6","article-title":"Radiographic evaluation of calcaneal fractures: To measure or not to measure","volume":"36","author":"Schepers","year":"2007","journal-title":"Skelet. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"665","DOI":"10.3113\/FAI.2011.0665","article-title":"Incidence of plantar lateral foot pain before and after the use of trial metal wedges in lateral column lengthening","volume":"32","author":"Ellis","year":"2011","journal-title":"Foot Ankle Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1302\/0301-620X.75B2.8444936","article-title":"Operative treatment of displaced intra-articular fractures of the calcaneum. Medium-term results","volume":"75","author":"Leung","year":"1993","journal-title":"J. Bone Jt. Surgery. Br. Vol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4055\/cios.2012.4.3.221","article-title":"Revisit of Broden\u2019s view for intraarticular calcaneal fracture","volume":"4","author":"Kwon","year":"2012","journal-title":"Clin. Orthop. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s00402-017-2714-y","article-title":"The sinus tarsi approach in displaced intra-articular calcaneal fractures","volume":"137","author":"Park","year":"2017","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_23","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":"ref_24","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3113\/FAI.2012.0079","article-title":"Current concepts review: Intra-articular fractures of the calcaneus","volume":"33","author":"Epstein","year":"2012","journal-title":"Foot Ankle Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1097\/00005131-199911000-00007","article-title":"Bohler\u2019s angle: Correlation with outcome in displaced intra-articular calcaneal fractures","volume":"13","author":"Loucks","year":"1999","journal-title":"J. Orthop. Trauma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/1071100718803333","article-title":"Extended Sinus Tarsi Approach for Treatment of Displaced Intraarticular Calcaneal Fractures Compared to Extended Lateral Approach","volume":"40","author":"Song","year":"2019","journal-title":"Foot Ankle Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/1938640017713616","article-title":"Comparison of Calcaneal Exposure Through the Extensile Lateral and Sinus Tarsi Approaches","volume":"11","author":"Bedigrew","year":"2018","journal-title":"Foot Ankle Spec."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1007\/s00264-020-04882-6","article-title":"Effectiveness of ankle arthroscopic debridement in acute, subacute ankle- bimalleolar, and trimalleolar fractures","volume":"45","author":"Ceccarini","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1053\/j.jfas.2021.04.006","article-title":"Arthroscopic Subtalar Arthrodesis as a Treatment Strategy for Subtalar Arthritis: A Systematic Review","volume":"60","author":"Banerjee","year":"2021","journal-title":"J. Foot Ankle Surg.: Off. Publ. Am. Coll. Foot Ankle Surg."},{"key":"ref_30","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\u2014Based study","volume":"33","author":"Nosewicz","year":"2012","journal-title":"Foot Ankle Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e0175","DOI":"10.1097\/MD.0000000000010175","article-title":"Clinical application of the sinus tarsi approach in the treatment of intra-articular calcaneal fracture","volume":"97","author":"Meng","year":"2018","journal-title":"Medicine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.fas.2015.03.001","article-title":"There is poor reliability of B\u00f6hler\u2019s angle and the crucial angle of Gissane in assessing displaced intra-articular calcaneal fractures","volume":"21","author":"Otero","year":"2015","journal-title":"Foot Ankle Surg.: Off. J. Eur. Soc. Foot Ankle Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s00264-011-1223-9","article-title":"The sinus tarsi approach in displaced intra-articular calcaneal fractures: A systematic review","volume":"35","author":"Schepers","year":"2011","journal-title":"Int. Orthop."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1007\/s00264-019-04318-w","article-title":"Comparison of sinus tarsi approach versus extensile lateral approach for displaced intra-articular calcaneal fractures Sanders type IV","volume":"43","author":"Lin","year":"2019","journal-title":"Int. Orthop."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/BOT.0000000000002085","article-title":"Acute Fixation of Displaced Intra-articular Calcaneus Fractures Is Safe Using the Sinus Tarsi Approach","volume":"35","author":"Joseph","year":"2021","journal-title":"J. Orthop. Trauma"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.injury.2013.03.014","article-title":"Open reduction and internal fixation of acute intra-articular displaced calcaneal fractures: A retrospective analysis of surgical timing and infection rates","volume":"44","author":"Ho","year":"2013","journal-title":"Injury"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1302\/0301-620X.92B5.23542","article-title":"Osteosynthesis of displaced intra-articular fractures of the calcaneum: A long-term review of 47 cases","volume":"92","author":"Makki","year":"2010","journal-title":"J. Bone Jt. Surgery. Br. Vol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/19\/10400\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:08:54Z","timestamp":1760166534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/19\/10400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,2]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["ijerph181910400"],"URL":"https:\/\/doi.org\/10.3390\/ijerph181910400","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,2]]}}}