title: Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey.
abstract: The treatment of intra-articular calcaneal fractures is controversial and randomised clinical trials are scarce. Moreover, the socio-economic cost remains unclear. The aim of this study was to estimate the incidence, treatment preferences and socio-economic cost of this complex fracture in the Netherlands. This data may aid in planning future clinical trials and support education. The method of study was of a cross-sectional survey design. A written survey was sent to one representative of both the traumatology and the orthopaedic staff in each hospital in the Netherlands. Data on incidence, treatment modalities, complications and follow-up strategies were recorded. The socio-economic cost was calculated. The average response rate was 70%. Fracture classifications, mostly by Sanders and Essex-Lopresti, were applied by 29%. Annually, 920 intra-articular calcaneal fractures (0.4% incidence rate) were treated, mainly with ORIF (46%), conservative (39%) and percutaneous (10%) treatment. The average non-weight-bearing mobilisation was 9 weeks (SD 2 weeks). An outcome score, mainly AOFAS, was documented by 7%. A secondary arthrodesis was performed in 21% of patients. The socio-economic cost was estimated to be euro21.5-30.7 million. Dutch intra-articular calcaneal fracture incidence is at least 0.4% of all fractures presenting to hospitals. Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.
authors.affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, CA Rotterdam, The Netherlands. t.schepers@erasmusmc.nl
authors.forename: T
authors.initials: T
authors.lastname: Schepers
authors.forename: E M M
authors.initials: EM
authors.lastname: van Lieshout
authors.forename: T M
authors.initials: TM
authors.lastname: van Ginhoven
authors.forename: M J
authors.initials: MJ
authors.lastname: Heetveld
authors.forename: P
authors.initials: P
authors.lastname: Patka
mesh_terms: D001174:Arthrodesis; D002111:Calcaneus / Q000293:injuries*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000145:classification / Q000191:economics / Q000601:surgery*; D019538:Health Care Surveys; D006801:Humans; D009426:Netherlands; D010818:Practice Patterns, Physicians'