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Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis

BACKGROUND: Calcaneal fractures are the most common tarsal bone fracture, and are often accompanied by heel pain, local swelling, tenderness, and inability to walk or stand. Surgical intervention results in better reconstruction of the calcaneal anatomy and reduces future complications; however, the...

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Autores principales: Peng, Chuangang, Yuan, Baoming, Guo, Wenlai, Li, Na, Tian, Heng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341246/
https://www.ncbi.nlm.nih.gov/pubmed/34397810
http://dx.doi.org/10.1097/MD.0000000000026717
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author Peng, Chuangang
Yuan, Baoming
Guo, Wenlai
Li, Na
Tian, Heng
author_facet Peng, Chuangang
Yuan, Baoming
Guo, Wenlai
Li, Na
Tian, Heng
author_sort Peng, Chuangang
collection PubMed
description BACKGROUND: Calcaneal fractures are the most common tarsal bone fracture, and are often accompanied by heel pain, local swelling, tenderness, and inability to walk or stand. Surgical intervention results in better reconstruction of the calcaneal anatomy and reduces future complications; however, the optimal incision approach is still controversial. The incision is exposed better with extensile lateral approach (ELA), while the sinus tarsi approach (STA) causes fewer complications. The purpose of this meta-analysis is to compare the outcomes of STA and ELA. MATERIALS AND METHODS: Published trials comparing ELA and STA in calcaneal fractures were included in our analysis. The quality of each study was assessed using the revised Jadad scale and the Newcastle–Ottawa scale. Two researchers (CP and BY) independently extracted data from all selected studies. Fixed- or random-effects models with mean differences and odds ratios were used to pool the continuous and dichotomous variables to determine the heterogeneity of the included studies. RESULTS: Calcaneal height and calcaneal width had high heterogeneity. Results showed that the incidence of incision complications in STA was lower than that in ELA (P < .001). There was high heterogeneity in operative time (I(2) = 97%), length of hospital stay (I(2) = 98%), Böhler angle (I(2) = 80%), Gissane angle (I(2) = 98%), and American Orthopaedic Foot & Ankle Society scores (I(2) = 73%). No source of heterogeneity was found by sensitivity analysis, subgroup analysis, or regression analysis, and the random-effects model was used. STA operative time was significantly shorter than ELA (P < .001). Length of hospital stay after STA was significantly shorter than after ELA (P = .002). There was no statistical difference in the Böhler and Gissane angles between STA and ELA. Postoperative American Orthopaedic Foot & Ankle Society scores after STA were higher than after ELA (P = .01). CONCLUSIONS: Results show that, compared with ELA, STA is superior for treating calcaneal fractures due to anatomical reduction of the calcaneus, reduction of incision complications incidence, and shortened operative time and postoperative stay.
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spelling pubmed-83412462021-08-07 Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis Peng, Chuangang Yuan, Baoming Guo, Wenlai Li, Na Tian, Heng Medicine (Baltimore) 6600 BACKGROUND: Calcaneal fractures are the most common tarsal bone fracture, and are often accompanied by heel pain, local swelling, tenderness, and inability to walk or stand. Surgical intervention results in better reconstruction of the calcaneal anatomy and reduces future complications; however, the optimal incision approach is still controversial. The incision is exposed better with extensile lateral approach (ELA), while the sinus tarsi approach (STA) causes fewer complications. The purpose of this meta-analysis is to compare the outcomes of STA and ELA. MATERIALS AND METHODS: Published trials comparing ELA and STA in calcaneal fractures were included in our analysis. The quality of each study was assessed using the revised Jadad scale and the Newcastle–Ottawa scale. Two researchers (CP and BY) independently extracted data from all selected studies. Fixed- or random-effects models with mean differences and odds ratios were used to pool the continuous and dichotomous variables to determine the heterogeneity of the included studies. RESULTS: Calcaneal height and calcaneal width had high heterogeneity. Results showed that the incidence of incision complications in STA was lower than that in ELA (P < .001). There was high heterogeneity in operative time (I(2) = 97%), length of hospital stay (I(2) = 98%), Böhler angle (I(2) = 80%), Gissane angle (I(2) = 98%), and American Orthopaedic Foot & Ankle Society scores (I(2) = 73%). No source of heterogeneity was found by sensitivity analysis, subgroup analysis, or regression analysis, and the random-effects model was used. STA operative time was significantly shorter than ELA (P < .001). Length of hospital stay after STA was significantly shorter than after ELA (P = .002). There was no statistical difference in the Böhler and Gissane angles between STA and ELA. Postoperative American Orthopaedic Foot & Ankle Society scores after STA were higher than after ELA (P = .01). CONCLUSIONS: Results show that, compared with ELA, STA is superior for treating calcaneal fractures due to anatomical reduction of the calcaneus, reduction of incision complications incidence, and shortened operative time and postoperative stay. Lippincott Williams & Wilkins 2021-08-06 /pmc/articles/PMC8341246/ /pubmed/34397810 http://dx.doi.org/10.1097/MD.0000000000026717 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 6600
Peng, Chuangang
Yuan, Baoming
Guo, Wenlai
Li, Na
Tian, Heng
Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title_full Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title_fullStr Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title_full_unstemmed Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title_short Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
title_sort extensile lateral versus sinus tarsi approach for calcaneal fractures: a meta-analysis
topic 6600
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341246/
https://www.ncbi.nlm.nih.gov/pubmed/34397810
http://dx.doi.org/10.1097/MD.0000000000026717
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