Sinus Tarsi Approach for Calcaneus Fractures

For decades the optimal treatment of intra-articular calcaneus fractures has been debated in the literature with no definitive solution reached. Although improved implant design and surgical techniques have led some to advocate for operative treatment, high rates of wound complications, particularly with use of the extensile lateral approach, have been touted as reasons to avoid operative fixation of calcaneus fractures. Given the advent of newer lower profile implants, better fixation techniques and improved surgical approaches that preserve the lateral vascular supply to the calcaneus, fewer complications and improved functional outcomes are more commonly reported in patients with operatively treated calcaneus fractures. Minimally invasive approaches, including the sinus tarsi approach, are being frequently used to treat displaced intra-articular calcaneus fractures with promising results. The literature has shown that through the use of these approaches, there has been a decreased rate of wound complications, hematoma formation, surgical time, and equivalent functional outcomes to the extensile lateral approach. This article focuses on describing the sinus tarsi approach, surgical technique, and outcomes.