Osteosynthesis or primary arthrodesis for displaced intra-articular calcaneus fractures Sanders type IV – A systematic review. Issue 3 (April 2022)

• Record Type: Journal Article
• Authors: Almeida, João F.; Vale, Cláudia; Gonzalez, Tânia; Gomes, Tiago M.; Oliva, Xavier Martin
• Is Part Of: Foot and ankle surgery. Volume 28:Issue 3(2022)
• Page Start: 281
• Page End: 287
• Publication Date: 2022-04
• Subjects: Displaced intra-articular calcaneal fracture -- Subtalar arthrodesis -- Osteosynthesis -- Sanders type IV -- AOFAS score; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2021.04.006
• Languages: English
• ISSNs: 1268-7731

Abstract

Abstract: Background: Displaced intra-articular calcaneus fractures (DIACF) Sanders type IV represent a challenge in its management and questions remain about the best treatment option available. This study aimed to compare the outcomes of primary subtalar arthrodesis (PSTA) and osteosynthesis in these fractures. Methods: Studies concerning DIACF Sanders type IV, from 2005 to 2020 were systematically reviewed. Only studies evaluating functional outcomes with American Orthopaedic Foot & Ankle Society ankle-hindfoot (AOFAS) score were admitted allowing for results comparison. Results: In total, 9 studies met the inclusion criteria. These reported on the results of 142 patients, from which 41 submitted to PSTA and 101 to osteosynthesis, with an average follow-up period over 2 years. We found a significant moderate negative correlation between the reported AOFAS score and the Coleman Methodology Score obtained. Late subtalar arthrodesis was 13.63% of the total osteosynthesis performed. Conclusions: Clinical outcomes after PSTA and osteosynthesis, for the treatment of Sanders type IV fractures, do not seem very different, yet careful data interpretation is crucial. Additional powered randomized controlled trials are necessary to assess which surgical strategy is better.