This 2015 JAAOS narrative review by Hsu et al. surveys surgical approaches for displaced intra-articular calcaneus fractures, asking whether newer minimally invasive techniques — limited-incision sinus tarsi ORIF, percutaneous fixation, and arthroscopic-assisted reduction — can reduce the high complication burden of the traditional extended L-shaped lateral approach.
When operating on a Sanders type II or low-comminution type III calcaneus fracture — especially in a diabetic, smoker, or obese patient — favor a limited sinus tarsi approach over the extensile lateral: the evidence shows dramatically lower wound complication rates (6% vs. 29%) with equivalent reduction quality, but you must act within 2 weeks of injury before early healing stiffens the fragments.
This 2015 JAAOS narrative review by Hsu et al. surveys surgical approaches for displaced intra-articular calcaneus fractures, asking whether newer minimally invasive techniques — limited-incision sinus tarsi ORIF, percutaneous fixation, and arthroscopic-assisted reduction — can reduce the high complication burden of the traditional extended L-shaped lateral approach.
When operating on a Sanders type II or low-comminution type III calcaneus fracture — especially in a diabetic, smoker, or obese patient — favor a limited sinus tarsi approach over the extensile lateral: the evidence shows dramatically lower wound complication rates (6% vs. 29%) with equivalent reduction quality, but you must act within 2 weeks of injury before early healing stiffens the fragments.