{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:46:50Z","timestamp":1777866410625,"version":"3.51.4"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The optimal surgical approach for displaced intra-articular calcaneal fractures (DIACFs) remains controversial. While the extensile lateral approach (ELA) has traditionally been preferred for complex fractures, the sinus tarsi approach (STA) has gained popularity due to its potentially lower soft tissue morbidity. However, comparative data focusing on patient-centered outcomes remain limited. This study aimed to compare clinical, radiological, functional, cosmetic, and complication outcomes between STA and ELA in Sanders type II\u2013IV DIACFs. Methods: A retrospective comparative cohort study was conducted including patients treated with open reduction and internal fixation using either STA or ELA between February 2019 and October 2024. Functional outcomes were assessed using the AOFAS Ankle\u2013Hindfoot Score and VAS. Radiological evaluation included B\u00f6hler and Gissane angles measured preoperatively, early postoperatively, and at final follow-up. Patient-centered outcomes included time to full weight bearing, return to work, heel width difference, and changes in shoe size. Complications were recorded throughout follow-up. Results: Baseline demographic and fracture characteristics were comparable between groups. Patients treated with STA demonstrated significantly shorter hospital stay, earlier progression to full weight bearing, and earlier return to work (p &lt; 0.001). Functional outcomes favored STA, with significantly lower VAS scores and higher AOFAS scores at final follow-up (p &lt; 0.05). No significant differences were observed between groups regarding B\u00f6hler or Gissane angles at any time point (p &gt; 0.05). Wound-related complications were significantly more frequent in the ELA group (p = 0.018), although overall complication rates were comparable. Conclusions: The sinus tarsi approach was associated with comparable radiological restoration to the extensile lateral approach while demonstrating earlier functional recovery and lower wound-related morbidity. Given the retrospective and non-randomized design, these findings should be interpreted as associations rather than causal effects. STA may represent a safe and effective surgical option in appropriately selected Sanders type II\u2013IV intra-articular calcaneal fractures.<\/jats:p>","DOI":"10.3390\/jcm15093420","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:03:47Z","timestamp":1777536227000},"page":"3420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sinus Tarsi Versus Extensile Lateral Approach for Sanders Type II\u2013IV Calcaneal Fractures: A Comparative Analysis of Functional Outcomes, Return to Work, and Cosmetic Parameters"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-7970","authenticated-orcid":false,"given":"Sahan","family":"Guven","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izzet","family":"Bingol","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, 06800 Ankara, Turkey"},{"name":"Department of Orthopedics and Traumatology, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cem","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umut","family":"Oktem","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasin","family":"Erdogan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Etlik City Hospital, 06170 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3451-3691","authenticated-orcid":false,"given":"Ali Said","family":"Nazligul","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Sincan Training and Research Hospital, 06949 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.13107\/jocr.2024.v14.i08.4700","article-title":"Functional and Radiological Outcome after Internal Fixation of Intra-articular Calcaneal Fractures","volume":"14","author":"Janeson","year":"2024","journal-title":"J. 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