Abstract:Objective To systematically evaluate the efficacy of sinus tarsi approach(STA) and conventional lateral extensile L-shape approach(ELA) in the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures. Methods The relevant literatures of randomized controlled trials(RCT) and clinical case-control trials(CCT) on the treatment of calcaneal fractures with STA and ELA were retrieved from domestic and foreign medical databases such as CNKI, VIP, WanFang, China Biomedical Literature Database（CBM）, Cochrane, PubMed, Embase, etc. through computer. The retrieval time was set from January 2010 to December 2021. After screening the eligible literatures according to the inclusive criteria for valid data extraction, meta-analysis was perform using RevMan 5.3 software. Results Totally 10 RCT involving 676 patients were included, and there were 338 patients(343 feet) in STA group and 338 patients(342 feet) in ELA group. Meta-analysis results showed that STA group was superior to ELA group in terms of in operation time ［ MD=-0.86, 95%CI (-13.31,-3.31), P＜0.01］, intraoperative bleeding ［ MD=-16.21, 95%CI (-25.58,-6.84), P＜0.01］, postoperative complications ［ MD=0.22, 95%CI (0.13,0.37), P＜0.01］, length of hospital stay ［ MD=-5.78, 95%CI (-10.63,-0.93), P＜0.05］, fracture healing time ［ MD=-1.37, 95%CI (-2.19,-0.54), P＜0.01］and excellent and good rate of Maryland score ［ MD=1.20, 95%CI (1.08,1.34),P＜0.01］. There was no significant difference in postoperative Bhler angle ［ MD=0.19, 95%CI (-0.44, 0.82), P＞0.05］and Gissane angle ［ MD=0.93, 95%CI (-0.20,2.07), P＞0.05］between two groups. Conclusion In the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures, STA has the advantages of shorter operation time, less intraoperative blood loss and postoperative complications and shorter fracture healing time and hospital stay compared with ELA, and there is no statistical difference in postoperative radiological evaluation of the foot.