title: Functional outcome and patient satisfaction after displaced intra-articular calcaneal fractures: a comparison among open, percutaneous, and nonoperative treatment.
abstract: The aim of the present study was to compare the outcomes of patients with a displaced calcaneal fracture treated by open reduction and internal fixation (ORIF), percutaneous treatment, or nonoperative methods. A retrospective cohort study was conducted at a level I trauma center of patients with a displaced intra-articular calcaneal fracture treated from January 1, 2002 to December 31, 2011. The patient-reported outcome measures included the Foot Function Index, American Orthopaedic Foot and Ankle Society hindfoot scale, Short Form-36, the EQ-5D from the EuroQol Group, and a 10-point visual analog scale. Clinical data were collected from 169 patients, and questionnaires were obtained from 78 patients (18 nonoperatively, 27 ORIF, and 33 percutaneously). The late intervention rate was significantly greater in the percutaneous group (n = 18; 30%) than in the ORIF group (n = 6; 12%) or the nonoperative group (n = 8; 13%; p = .030). Significantly more disability was reported in the nonoperative group (median Foot Function Index score, 40 points) than in the ORIF group (median, 16 points; p = .010) or in the percutaneous group (median, 21 points; p = .034). In conclusion, the operatively treated patients (ORIF and percutaneous treatment) reported better functional outcome scores (Foot Function Index and American Orthopaedic Foot and Ankle Society hindfoot scale) than did the nonoperatively treated patients.
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: A Siebe
authors.initials: AS
authors.lastname: De Boer
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Esther M M
authors.initials: EM
authors.lastname: Van Lieshout
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Dennis
authors.initials: D
authors.lastname: Den Hartog
authors.affiliation: Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Weerts
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Michael H J
authors.initials: MH
authors.lastname: Verhofstad
authors.affiliation: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: t.schepers@erasmusmc.nl.
authors.forename: Tim
authors.initials: T
authors.lastname: Schepers
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000293:injuries*; D015331:Cohort Studies; D003358:Cosmetics; D005260:Female; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D003358:Cosmetics
keywords: calcaneus; complication; conservative treatment; joint depression; open reduction internal fixation; trauma