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The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis.

Theerawoot Tharmviboonsri·Thos Harnroongroj·Chayapat Wannawongtikul·Bavornrit Chuckpaiwong·Penpun Lertwattanachai·Ishthayapong Kanjanakeereewong
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Abstract

BACKGROUND: This study evaluated the incidence of calcaneal malunion after minimally invasive sinus tarsi approach (MIS-STA) in displaced intra-articular calcaneal fractures (I-ACFs) and identified related descriptive factors of calcaneal malunion. METHODS: A retrospective review of 99 displaced I-ACFs treated with MIS-STA was conducted. Demographic data, pre-operative radiographs, and operative details were analyzed. Outcomes included numerical rating scale (NRS) pain scores at rest and during activities of daily living (ADL), Foot and Ankle Ability Measure (FAAM) for ADL and radiographic parameters. Logistic regression was used to identify descriptive factors associated with malunion. RESULTS: Malunion occurred in 33/99 cases (33.3%). The significant descriptive factors were the initial B&#xf6;hler angle <&#x202f;0.5 &#xb0;, time to surgery >&#x202f;12.5 days, and Sanders type &#x2265;&#x202f;III. Malunion patients had significantly worse NRS and FAAM scores (p&#x202f;&#x2264;&#x202f;0.001). CONCLUSION: Calcaneal malunion after MIS-STA occurred in one-third of cases, with three descriptive factors identified and poorer outcomes observed. LEVEL OF EVIDENCE: III, Comparative retrospective study with binary logistic regression analysis.

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HumansCalcaneusRetrospective StudiesFractures, MalunitedFemaleIntra-Articular FracturesFracture Fixation, InternalMaleAdultIncidenceMiddle AgedLogistic ModelsAgedB&#xf6;hler angleCalcaneal malunionDescriptive factorsDisplaced intra-articular calcaneal fracturesSanders classificationSinus tarsi approachSurgical timingJournal Article

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Theerawoot Tharmviboonsri, Thos Harnroongroj, Chayapat Wannawongtikul, Bavornrit Chuckpaiwong, Penpun Lertwattanachai, Ishthayapong Kanjanakeereewong. 2026-03-26. The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis.. https://doi.org/10.1016/j.fas.2026.03.009

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Journal Article resourceAdult subjectAged subjectFemale subjectFracture Fixation, Internal subjectHumans subjectIncidence subjectJournal Article subjectMale subjectMiddle Aged subject

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