Subtalar arthroscopy-assisted MIPO technique for the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures via the sinus tarsi approach: A retrospective study

Abstract

Background: To explore the efficacy of internal fixation with Minimally invasive plate osteosynthesis (MIPO) technology through the sinus tarsi approach assisted by subtalar arthroscopy in the treatment of Sanders type Ⅱand Ⅲ calcaneal fractures. Methods: A retrospective analysis was conducted on the data of 55 patients with Sanders type II and III calcaneal fractures admitted to the Cangzhou Clinical College of Integrated Traditional Chinese and Western Medicine of Hebei Medical University from January 2023 to March 2024. The patients were divided into three groups based on different treatment methods: subtalar arthroscopy-assisted (MIPO technology) internal fixation treatment through the sinus tarsi approach (arthroscopic group, 17 patients), the sinus tarsi approach (STA group, 20 patients), and the extensile lateral approach (ELA group, 18 patients). This study compared the preoperative waiting time for swelling reduction, surgical operation time, incidence of incision complications, fracture reduction degree, follow-up time, and surgical score among three groups of patients. Results:There were no statistically significant differences in the preoperative general information among the three groups of patients, making them comparable. In terms of surgical operation time, X-ray findings, and differences in dorsiflexion and plantarflexion, no significant differences were observed among the groups. The incidence of incision complications, postoperative heel widening compared to that on the contralateral side, and differences in the varus and valgus angles were lower in the arthroscopy group than in the STA group and significantly lower in the STA group than in the ELA group. The visual analogue scale (VAS) score of the postoperative arthroscopy group was lower than that of the other two groups, while the American Orthopedic Foot and Ankle Society (AOFAS) score was greater in the arthroscopy group than in the other two groups. Conclusion: Subtalar arthroscopy-assisted MIPO technology for internal fixation using the sinus tarsi approach is a promising method for treating Sanders type II and III fractures. This approach has benefits such as less trauma, early treatment, and effective fracture reduction. It is particularly advantageous for young adults or athletes because it minimizes incision complications and reduces tissue scarring.