Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis
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 inc...
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| Veröffentlicht in: | Medicine (Baltimore) 2021-08, Vol.100 (31), p.e26717-e26717 |
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| creator | Peng, Chuangang Yuan, Baoming Guo, Wenlai Li, Na Tian, Heng |
| description | 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.
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.
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 |
| doi_str_mv | 10.1097/MD.0000000000026717 |
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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.
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 (I2 = 97%), length of hospital stay (I2 = 98%), Böhler angle (I2 = 80%), Gissane angle (I2 = 98%), and American Orthopaedic Foot & Ankle Society scores (I2 = 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).
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.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000026717</identifier><identifier>PMID: 34397810</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Calcaneus - injuries ; Calcaneus - surgery ; Fractures, Bone ; Humans ; Length of Stay ; Orthopedic Procedures - methods ; Orthopedic Procedures - standards ; Postoperative Complications ; Systematic Review and Meta-Analysis ; Treatment Outcome</subject><ispartof>Medicine (Baltimore), 2021-08, Vol.100 (31), p.e26717-e26717</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3553-b14bff4f3e7b646abd030fa918af4a04517da34039b8174bbcffb5c42067616d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341246/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341246/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34397810$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peng, Chuangang</creatorcontrib><creatorcontrib>Yuan, Baoming</creatorcontrib><creatorcontrib>Guo, Wenlai</creatorcontrib><creatorcontrib>Li, Na</creatorcontrib><creatorcontrib>Tian, Heng</creatorcontrib><title>Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>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.
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.
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 (I2 = 97%), length of hospital stay (I2 = 98%), Böhler angle (I2 = 80%), Gissane angle (I2 = 98%), and American Orthopaedic Foot & Ankle Society scores (I2 = 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).
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.</description><subject>Calcaneus - injuries</subject><subject>Calcaneus - surgery</subject><subject>Fractures, Bone</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Orthopedic Procedures - methods</subject><subject>Orthopedic Procedures - standards</subject><subject>Postoperative Complications</subject><subject>Systematic Review and Meta-Analysis</subject><subject>Treatment Outcome</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtP3DAURi3UCqbAL0Cqsuwm1G8nXSAhHi0SqJvC1rr22EyoJxl8Ex7_HsMAfXhhS_a5x77-CNljdJ_R1ny9ON6nfwbXhpkNMmNK6Fq1Wn4gs7KratMauUU-Id5QyoThcpNsCSla0zA6I1cnD2PosUuhSjCGDKm6CxknrLDryzxCxq6C1SoP4BdVHHLlIXnoQyFjBj9OOeC36rBahhFq6CE9Yoc75GOEhGH3dd0ml6cnv45-1Oc_v58dHZ7XXiglaseki1FGEYzTUoObU0EjtKyBKIFKxcwchKSidQ0z0jkfo1NecqqNZnoutsnB2rua3DLMfejH0oJd5W4J-dEO0Nl_T_puYa-HO9sIybjURfDlVZCH2yngaJcd-pBS6XCY0HKlWcsVl7ygYo36PCDmEN-vYdQ-J2Ivju3_iZSqz3-_8L3mLYICyDVwP6QSAP5O033IdlE-eFy8-JRpec0pZ7ShmtbPaiGeANdcl9o</recordid><startdate>20210806</startdate><enddate>20210806</enddate><creator>Peng, Chuangang</creator><creator>Yuan, Baoming</creator><creator>Guo, Wenlai</creator><creator>Li, Na</creator><creator>Tian, Heng</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210806</creationdate><title>Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis</title><author>Peng, Chuangang ; Yuan, Baoming ; Guo, Wenlai ; Li, Na ; Tian, Heng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3553-b14bff4f3e7b646abd030fa918af4a04517da34039b8174bbcffb5c42067616d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Calcaneus - injuries</topic><topic>Calcaneus - surgery</topic><topic>Fractures, Bone</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedic Procedures - standards</topic><topic>Postoperative Complications</topic><topic>Systematic Review and Meta-Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peng, Chuangang</creatorcontrib><creatorcontrib>Yuan, Baoming</creatorcontrib><creatorcontrib>Guo, Wenlai</creatorcontrib><creatorcontrib>Li, Na</creatorcontrib><creatorcontrib>Tian, Heng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peng, Chuangang</au><au>Yuan, Baoming</au><au>Guo, Wenlai</au><au>Li, Na</au><au>Tian, Heng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2021-08-06</date><risdate>2021</risdate><volume>100</volume><issue>31</issue><spage>e26717</spage><epage>e26717</epage><pages>e26717-e26717</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>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.
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.
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 (I2 = 97%), length of hospital stay (I2 = 98%), Böhler angle (I2 = 80%), Gissane angle (I2 = 98%), and American Orthopaedic Foot & Ankle Society scores (I2 = 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).
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.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>34397810</pmid><doi>10.1097/MD.0000000000026717</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Calcaneus - injuries Calcaneus - surgery Fractures, Bone Humans Length of Stay Orthopedic Procedures - methods Orthopedic Procedures - standards Postoperative Complications Systematic Review and Meta-Analysis Treatment Outcome |
| title | Extensile lateral versus sinus tarsi approach for calcaneal fractures: A meta-analysis |
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