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Objectives: To investigate whether the sinus tarsi approach (STA) allows for a similar anatomical reduction of the posterior talocalcaneal facet as the extended lateral approach (ELA) and compare the rate of postoperative wound complications., Design: Retrospective., Setting: Level 1 trauma center., Patients: All consecutive patients from 2012 to 2015 with a closed displaced intra-articular calcaneal fracture Sanders type II and III surgically treated with the ELA (N = 60) and the STA (N = 65)., Main Outcome Measurements: Wound complications, timing of surgery, operative time, length of postoperative hospitalization, and reduction of the posterior facet and calcaneal body., Results: Incidence of wound complications, time to surgery, postoperative duration of hospital admission, and number of hospital admissions because of wound complications were significantly different between the ELA group and STA group. There was no significant difference in restoration of calcaneal anatomy with either approach. Importantly, the STA was performed in a median duration of 105 minutes and the ELA in a median of 134 minutes, accounting for nearly half an hour difference in operating time (P < 0.001)., Conclusions: The largest benefit of the STA was found in the significant reduction in wound complications and operative time, where time to closure may have accounted for the latter difference. This difference was without a compromise in reduction. Additional studies comparing functional outcome, especially rates of subtalar arthrosis, will be needed to determine the long-term benefits of STA., Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Objective: The objective of the present study was (1) to identify predictors of both nonunion and postoperative wound infections (POWI) and (2) to assess the union and complication rate following posttraumatic subtalar arthrodesis (STA)., Design: Retrospective comparative cohort study., Setting: Level 1 trauma center., Patients: All consecutive adult patients with STA following traumatic injuries between 2000 and May 2015., Intervention: STA for posttraumatic deformities., Main Outcome Measurements: Union (described as a combination of radiographic signs of osseous bridging and a clinically fused joint) and POWI as classified by the Centers for Disease and Control., Results: A total number of 93 (96 feet) patients met the inclusion criteria. Union was achieved in 89% of patients. For primary, secondary in situ, and secondary correction arthrodesis, these percentages were 94%, 84,% and 90%, respectively (NS). The union rate significantly increased over time (P = 0.02). In 17 patients (18%), a POWI occurred, of which 2 were classified as superficial and 15 as deep POWIs. The POWI rate did not differ between the groups. Alcohol, nicotine, and drug abuse were not significantly associated with the occurrence of POWIs. Patients with an open fracture or an infection following open reduction internal fixation had a greater risk of a POWI following STA (P = 0.03 and P = 0.04, respectively)., Conclusions: We could not identify predictors for nonunion. In 18% of the patients, an infectious complication following surgery occurred. Patients with an open fracture or an infection after primary surgical treatment (ie, open reduction internal fixation) have a higher chance of POWIs following STA. The union rate following posttraumatic STA is 89%., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Introduction: Fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) has proven to be a valuable imaging modality with high diagnostic accuracy for the detection of bone infections. However, the physiological uptake values for F-FDG in the long bones of the lower extremity have not been established yet. This hampers correct interpretation of a F-FDG-PET/CT scan., Purpose: The purpose of this study was to determine the physiological uptake values of F-FDG in the long bones of the lower extremities, including the femur and the tibia., Patients and Methods: We retrospectively analyzed the F-FDG-PET/CT scan of 84 consecutive patients from our database. F-FDG uptake parameters included mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax). Both SUVs were determined in the diaphyseal region of the femur and the tibia., Results: SUVmean for the femoral diaphysis was 0.46 [95% confidence interval (CI) 0.42-0.49] and SUVmax was 0.81 (95% CI 0.74-0.88). For the tibial diaphysis, SUVmean was 0.34 (95% CI 0.32-0.37) and SUVmax was 0.61 (95% CI 0.56-0.65). SUVmean and SUVmax of the femur were significantly higher than that of the tibia (both P<0.01). SUVs for men were not significantly different from that for women and did not discriminate between age classes., Conclusion: For a correct interpretation of the F-FDG-PET/CT scan, we have determined the F-FDG uptake values in the long bones of the femur and the tibia. A SUVmean less than 0.5 and a SUVmax less than 0.8 can be considered as normal bone, irrespective of sex or age.