Efficacy of Sinus Tarsal Approach Compared With Conventional L-Shaped Lateral Approach in the Treatment of Calcaneal Fractures: A Meta-Analysis

Abstract

Background: This study aims to compare the efficacy of the sinus tarsal approach (STA) with that of the conventional L-shaped lateral approach (CLSLA) in the treatment of calcaneal fractures by meta-analysis. Methods: PubMed, Embase, Web of Science, the Chinese National Knowledge Infrastructure, and China Wanfang database were searched to collect clinical randomized or non-randomized controlled trials of STA and CLSLA in the treatment of calcaneal fractures from January 2010 to May 2020. The data were analyzed by Stata 15.0 software. Results: A total of 12 clinical trials were included, all of which were retrospective studies, including 961 patients. The results showed that when STA was compared with CLSLA, there was no difference in operation time with mean difference (MD) = -5.51 [95% confidence interval (CI): -12.57 to 1.55, P > 0.05], less bleeding during operation with MD = -18.49 (95% CI:-23.79 to -13.18), no difference in Böhler angle after an operation with MD = 0.78 (95% CI: -0.09 to 1.65) and in Gissane angle with MD = -0.07 (95% CI: -1.90 to 1.77), no difference in American Orthopedic Foot and Ankle Society score with MD = 2.16 (95% CI: -1.07 to 5.38), higher-excellent and better rate of Maryland food function with relative ratio = 1.12 (95% CI: 1.04 to 1.20), and lower of incidence of postoperative complications with relative ratio = 0.23 (95% CI: 0.14-0.37). Conclusion: STA was more effective than CLSLA in the treatment of calcaneal fractures. Moreover, STA had advantages in less intraoperative bleeding, higher-excellent and better rate of Maryland foot function, lower incidence of postoperative complications, and higher safety.

Keywords: calcaneal fracture; calcaneal fracture non-union; meta-analysis; onventional L-shaped lateral approach; sinus tarsal approach.