106 | wetenschapsdag 2023 Sessie 3d: Architecturale Hoogstandjes en Chirurgische Laagstandjes 3 Auteurs R. Eelsing, A.M. Ahmadi, J.A. Halm, T. Schepers Abstract titel Geographical differences in wound complication rates following the sinus tarsi approach in displaced intra-articular calcaneal fractures – A systematic review of the literature Background The sinus tarsi approach (STA) has gained popularity for the treatment of displaced intra-articular calcaneal fractures (DIACFs). No large studies comparing wound complications world-wide after STA surgery are available. The aim of this systematic review was to compare postoperative wound complication (POWC) and postoperative wound infection (POWI) rates following STA surgery between continents, countries, and their differences in climate. Methods A literature search was performed using the databases of PubMed, Embase and the Cochrane Library. Studies published before January 1st 2000, including <10 patients and written in a language other than English were excluded Results In total, 88 studies containing 4414 surgeries via STA from 20 different countries, were included. The mean POWC was 5.9% and mean POWI was 4.5%. The highest mean POWC rate was in North America (8.5%) and the lowest in Asia (3.4%). No significant differences were wound in the POWC and POWI rates between countries (p=0.179 and p=0.571, respectively), but significant differences were found between the POWC and POWI rates between continents (p=0.046 and p=0.014, respectively). The number of surgeries per year and climate differences, as represented by mean local temperature, were not correlated with both the POWC/POWI rates and functional outcome score Conclusion Significant differences between the POWC and POWI rates were found between continents but not between individual countries. With a mean POWC of 5.9% and mean POWI rate of 4.5%, STA has an intrinsic low risk for complications given the minimally invasive nature of the approach and is inevitably becoming the gold standard for calcaneal surgery.
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