title: An outcomes assessment of intra-articular calcaneal fractures, using patient and physician's assessment profiles.
abstract: Thirty-six patients with intra-articular displaced calcaneal fractures were examined to determine both physician- and patient-based outcomes. Three groups were selected. Group A was treated with open reduction and internal fixation, group B was treated with open reduction internal fixation and supplemental bone graft augmentation and the patients in group C were treated with plaster cast immobilisation and no formal operative treatment. All cohorts were well matched for age, sex and severity of injury. Patients were evaluated using both the American Foot and Ankle Society Scoring System (AFASS) and the short form 36 (SF-36). Minimum time to follow up was 4 years. No significant difference was observed between the three groups with regards to pain and functional outcomes using the AFASS score (P>0.05). No difference was observed between the three groups using the SF-36 score (P>0.1). A statistically significant difference was observed, using radiological criteria, between both groups A and B when compared to the non-operative group C. The rate of wound infection in groups A and B was 31.5%. No correlation was found between the SF-36 score and the AFASS score. No correlation was found between the radiological score and either the SF-36 or the AFASS score. This study has found that the conservative treatment of calcaneal fractures can produce satisfactory outcomes with lower morbidity than surgically treated fractures.
authors.affiliation: Department of Orthopaedic Surgery, Cork University Hospital, Wilton, Cork, Ireland. jgk1@hotmail.com
authors.forename: J G
authors.initials: JG
authors.lastname: Kennedy
authors.forename: W M
authors.initials: WM
authors.lastname: Jan
authors.forename: A J
authors.initials: AJ
authors.lastname: McGuinness
authors.forename: K
authors.initials: K
authors.lastname: Barry
authors.forename: J
authors.initials: J
authors.lastname: Curtin
authors.forename: W F
authors.initials: WF
authors.lastname: Cashman
authors.forename: G B
authors.initials: GB
authors.lastname: Mullan
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery* / Q000628:therapy; D002111:Calcaneus / Q000293:injuries* / Q000601:surgery; D002370:Casts, Surgical; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D005270:Femur Head / Q000637:transplantation; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D013530:Surgical Wound Infection; D014184:Transplantation, Homologous; D016896:Treatment Outcome