Meta-analysis Of The Efficacy Of Sinus Tarsi Approach And Traditional Extensile Lateral Approach In The Treatment Of Sanders Type Ⅱ And Ⅲ Calcaneal Fractures

Objective:To systematically evaluate the efficacy of transtarsal approach(sinus tarsi approach,STA)and traditional lateral L-shaped approach(extensile lateral approach,ELA)in the treatment of Sanders type II and III calcaneal fractures.Methods:Computer searched domestic and foreign medical databases such as CNKI,VIP,WANFANG,China Biomedical Literature Database,CBM,Cochrane,Pubmed,Embase,etc.for the treatment of calcaneus through the sinus tarsi approach and the lateral L-shaped approach.The relevant literatures of randomized controlled trials and clinical case-control studies of fractures were retrieved from January 2010 to December 2021.Eligible literatures were screened to extract valid data,and Rev Man5.3 software was used to perform meta-analysis on the data.Results:A total of 10 clinical randomized controlled trials were included in this study,with a total of 676 patients.Meta-analysis results showed that the two groups were significantly different in operation time(MD=-0.86,95%CI:-13.31～-3.31,P=0.001),intraoperative blood loss(MD=-16.21,95%CI:-25.58～-6.84,P=0.0007),postoperative complications(RR=0.22,95%CI: 0.13～0.37,P<0.0001),length of hospital stay(MD=-5.78,95%CI:-10.63～-0.93,P=0.02),fracture healing time(SMD=-1.37,95%CI:-2.19～-0.54,P=0.001),excellent and good rate of Maryland score(RR=1.20,95%CI: 1.08～1.34,P=0.0008)The difference was statistically significant There was no significant difference in postoperative B?hler angle(MD=0.19,95%CI: 0.44～-0.82,P=0.55)and Gissane angle(MD=0.93,95%CI:-0.20～2.07,P=0.11).Conclusion:Compared with the traditional lateral L-shaped surgical approach,the transtarsal approach in the treatment of Sanders type II and III calcaneal fractures has the advantages of shorter operation time,less intraoperative blood loss and postoperative complications,and shorter fracture healing time and hospital stay.and other advantages,and the postoperative radiological evaluation of the foot was no different from the traditional one.