Objective To investigate the anatomical characteristics and clinical efficacy of the transtarsal sinus ap-proach internal fixation for treatment of calcaneal fractures.Methods Twenty feet specimens from adult cadaver were performed anatomical measurement in order to obtain the safe surgical scope.Within this range,the internal fixation via tarsal sinus approach was used to treat 32 patients of calcaneal fractures.Böhler angle,Gissane angle,calcaneal width,calcaneal height,and the incidence of complications were recorded.Clinical efficacy was evaluated by using the MaryLand score and AOFAS ankle-hindfoot score.Results ① The safe operation scope was obtained by anatomical measurements,which was used to avoid to damage the the sural nerve in the treatment of calcaneal fractures by tran-starsal sinus approach.The horizontal direction was 11～28(16.90±4.93)mm,the vertical direction was 12～25(17.55±4.51)mm,and the diagonal direction was 28～56(43.60±8.44)mm.②All patients were followed up for 12～22 months.There were no postoperative complications such as incision infection,nerve injury or internal fixation failure.All fractures healed within12～18 weeks.Böhler angle,Gissane angle,calcaneal width and calcaneal height:at 3 and 6 months after surgery,they were significantly better than before surgery(P<0.01),but there were no differ-ences between 6 and 3 months after surgery(P>0.05).The MaryLand scores and the AOFAS ankle-hindfoot scores of ankle joint:at 3,6 and 12 months after surgery,they were higher than 1 month after surgery(P<0.05),and at 6 and 12 months after surgery,they were higher than those of 3 months after surgery(P<0.05);there was no statistical difference in scores between 6 and 12 months after surgery(P>0.05).Conclusions Within a safe surgical scope,the internal fixation for treatment of calcaneal fractures by transtarsal sinus approach can effectively expose the calca-neal articular surface,which is conducive to the fracture reduction and plate fixation,and reduce the incidence of soft tissue and nerve injuries.
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