In the management of displaced intraarticular calcaneal fractures, patients with light labor and no secondary gains had superior results with operative treatment with restoration of Böhler angle and articular surface, according to study results.
Eighty-two patients with CT-verified displaced intraarticular calcaneal fractures (DIACFs) were initially randomly assigned to undergo operative treatment with open reduction and screw/plate fixation or nonoperative treatment. Fifty-eight patients were available after 8 to 12 years of follow-up and were included in the final evaluation.
The researchers further divided the patients using a post hoc analysis model into a 50% superior outcome group and 50% inferior outcome group, regardless of treatment given.
Main outcome measures included VAS pain and function, SF-36 general health outcome questionnaire, American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale and the Olerud-Molander score. The researchers compared age, sex, fracture type, treatment given, Böhler angle, residual articular surface step-off at healing, type of occupation and injury insurance between the two groups.
Study results showed higher physical SF-36, AOFAS and Olerud-Molander scores in the superior group vs. the inferior group.
The researchers found operative treatment, better Böhler angle and articular surface restoration, light labor/retirement and absence of injury insurance were also more common in the superior group.
Between the superior and inferior groups, age, sex, pretreatment Böhler angle and fracture type were comparable, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.