Minimally invasive surgical techniques compared to an extensile lateral approach in the management of displaced intra-articular calcaneal fractures. A systematic review and meta-analysis of randomised controlled trials.
Systematic Review
Developments in minimally invasive surgical techniques (MIS) have sparked debate over the optimal intervention for calcaneal fractures. This meta-analysis compares the extensile lateral approach (ELA) to two MIS techniques; the sinus tarsi approach and percutaneous approaches./r/nA systematic search was conducted across seven databases for randomised control trials (RCTs). The clinical outcomes were wound complications, functional scores (American Orthopaedic Foot & Ankle Society score, and Maryland Foot Score) and radiological measures (Böhler’s and Gissane’s angles)./r/nFourteen RCTs (n = 1367; mean age: 36.3 years; 25.7 % female) were included. MIS significantly reduced wound complications compared to ELA (RR 6.48, 95 %CI 4.03-10.41, p < 0.00001, n = 1380, GRADE: High). Functional scores favoured MIS, and radiological outcomes were equivalent./r/nBoth MIS techniques reduce wound complications, improve functional outcomes, and achieve comparable anatomical reduction, making them suitable alternatives to the extensile lateral approach, to significantly improve patient’s outcomes./r/nLevel 1.
