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Factors affecting long-term treatment results of displaced intraarticular calcaneal fractures: a post hoc analysis of a prospective, randomized, controlled multicenter trial
Stockholm Fotkirurgklinik, Sofiahemmet, Stockholm, Sweden.
Department of Surgical and Perioperative Sciences (Orthopaedics-Sundsvall), Umeå University, Umeå, Sweden.
Stockholm Spine Center, Stockholm, Sweden.
Örebro University Hospital. Department of Molecular Medicine and Surgery (Orthopaedics), Karolinska Institute, Stockholm, Sweden.
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2014 (English)In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 28, no 10, 564-568 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To study the factors affecting long-term treatment results of displaced intraarticular calcaneal fractures (DIACFs).

DESIGN: A post hoc analysis.

SETTINGS: Tertiary care teaching hospitals.

PATIENTS: Eight to twelve years of results from a randomized controlled multicenter trial of operative versus nonoperative treatment (n = 56) were divided into 2 groups: the superior 50% results (n = 28) and the inferior 50% results (n = 28), regardless of the treatment given. The determinant of this division was a visual analog score for pain and function.

INTERVENTIONS: The operative treatment consists of open reduction and internal fixation, whereas the nonoperative treatment consists of nonweight bearing and early range of motion exercise.

MAIN OUTCOME MEASUREMENTS: A visual analog score for pain and function, the short-form 36 (SF-36) general health outcome questionnaire, the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale, and Olerud-Molander score. We compared age, sex, fracture type (Sanders classification), treatment given, Böhler angle, residual articular surface step-off at healing, type of occupation, and injury insurance between the 2 groups.

RESULTS: Patients of the superior group had higher physical SF-36, AOFAS, and Olerud-Molander score than in the inferior group. Operative treatment, better Böhler angle and articular surface restoration, light labor/retirement, and absence of injury insurance were more common in the superior group. Age, sex, pretreatment Böhler angle, and fracture type were comparable in the superior and inferior groups.

CONCLUSIONS: The decision making for definitive treatment of intraarticular calcaneal fractures is multifactorial with a spectrum of results and trends such as patient demographic features that should be considered in choosing the best treatment option.

LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2014. Vol. 28, no 10, 564-568 p.
Keyword [en]
calcaneal fractures; long-term results; VAS; SF-36; AOFAS; operative treatment; nonoperative treatment
National Category
Orthopedics Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:oru:diva-55791DOI: 10.1097/BOT.0000000000000149ISI: 000342750900006PubMedID: 24824095Scopus ID: 2-s2.0-84915773854OAI: oai:DiVA.org:oru-55791DiVA: diva2:1074590
Available from: 2017-02-15 Created: 2017-02-15 Last updated: 2017-10-18Bibliographically approved

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