Is Early Fixation of Intra-Articular Calcaneal Fractures via the Sinus Tarsi Approach Safe?

Background: The aim of this study was to investigate the relationship between surgical timing and treatment outcomes in calcaneal fractures treated with the sinus tarsi approach. Methods: Eighty-eight patients with displaced intra-articular calcaneal fractures who were operated on between March 2015 and March 2022 were included in the study. The patients were divided into two groups: those operated on within 3 days post-injury (Gearly, n: 32) and those operated on past 3 days post-injury (Glate, n: 56) with respect to admission year. The groups were compared in terms of Bohler angle (BA), Gissane angle (GA), calcaneal length (CL), calcaneal height (CH), complications, and American Orthopedic Foot and Ankle Society (AOFAS) score. In addition, we made comparisons based on fracture type. Patients with Sanders type 2 and type 3 fractures were included in Group S2–3 (n: 58; median age: 45.2), and those with Sanders type 4 fractures were included in Group S4 (n: 30; median age: 46.5). Results: The median follow-up period of our patients was 62.5 (min: 24; max: 100) months. No statistically significant differences were observed between the groups in terms of comorbidities, age, gender, mechanism of injury, Sanders fracture type classification, and operative and follow-up times. There were no statistically significant differences between the groups regarding postoperative AOFAS scores. The main complication was screw head irritation on the posterior foot while wearing shoes in both the early and delayed fixation groups. There were no statistically significant differences between the groups regarding soft tissue complications and postoperative radiological parameters. Conclusions: The sinus tarsi approach is safe for the early fixation of intra-articular calcaneal fractures and can even be safely applied for intra-articular Sanders type 4 fractures.