Evaluate the Extensile Lateral Technique in Comparison to the Sinus Tarsi Method for Treating Displaced Intra-Articular Calcaneal Fractures

ABSTRACT: Background: Displaced intra-articular calcaneal fractures are among the most challenging injuries to treat due to their complex anatomy and associated soft tissue complications. Two widely used surgical approaches the Extensile Lateral Approach (ELA) and the Sinus Tarsi Approach (STA)—offer different advantages and limitations. This study aims to compare the clinical, radiological, and functional outcomes of these two techniques. Methods: A prospective comparative study was conducted on 60 patients diagnosed with displaced intra-articular calcaneal fractures (Sanders Type II and III). Patients were equally divided into two groups: Group A (n=30) underwent open reduction and internal fixation via the Extensile Lateral Approach, while Group B (n=30) underwent fixation using the Sinus Tarsi Approach. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographic parameters, operative time, complications, and recovery profiles were also assessed. Results: Both groups achieved satisfactory anatomical reduction and improved radiological parameters. However, the STA group showed a statistically significant reduction in operative time and soft tissue complications. Functional outcomes, as measured by AOFAS scores, were slightly better in the STA group at follow-ups. Wound-related complications were notably higher in the ELA group, including superficial infections, flap necrosis, and wound dehiscence. Conclusion: While both techniques are effective in the surgical management of displaced intra-articular calcaneal fractures, the Sinus Tarsi Approach offers a less invasive, safer alternative with reduced soft tissue morbidity and faster recovery. It is especially suitable for less complex fractures and in patients where soft tissue preservation is essential. Surgeon experience and careful case selection remain critical to achieving optimal results. Keywords: Displaced intra-articular calcaneal fractures, extensile lateral approach, sinus tarsi approach, surgical outcomes, calcaneus, AOFAS score.