title: Prospective randomized trial comparing open reduction and internal fixation with minimally invasive reduction and percutaneous fixation in managing displaced intra-articular calcaneal fractures.
abstract: OBJECTIVE
  Managing displaced intra-articular calcaneal fractures remains controversial. A prospective randomised trial was undertaken to compare open reduction and internal fixation (ORIF) with minimally invasive reduction and percutaneous fixation (MIRPF).
  
  
  METHODS
  Forty-five displaced intra-articular calcaneal fractures were randomised to undergo either ORIF (n = 23) or MIRPF (n = 22). Patients were followed up clinically and radiologically for a minimum of one year postoperatively. The primary outcome measure was wound-healing complication. Functional outcome was assessed using Creighton Nebraska Health Foundation (CNF) scale, and radiological outcome was assessed using plain radiographs and computed tomography (CT) scans.
  
  
  RESULTS
  Of the 23 heels in the ORIF group, seven (30%) had wound-healing problems, compared with none in the MIRPF group (p = 0.005). There was no statistically significant difference in radiological outcomes between groups, as measured by Böhler's angle, Gissane's angle and Score Analysis of Verona (SAVE). Median time to return to work was two weeks earlier (p = 0.004), and the functional outcome score (CNF scale) at one year of follow-up was better (p = 0.013) following MIRPF compared with ORIF.
  
  
  CONCLUSIONS
  MIRPF is associated with fewer wound-healing problems, better functional outcome and earlier return to work compared with ORIF.
authors.affiliation: All India Institute of Medical Sciences, Orthopaedics, New Delhi, India, venkatortho4@gmail.com.
authors.forename: Venkatesan
authors.initials: V
authors.lastname: Sampath Kumar
authors.forename: Kanniraj
authors.initials: K
authors.lastname: Marimuthu
authors.forename: Suresh
authors.initials: S
authors.lastname: Subramani
authors.forename: Vijay
authors.initials: V
authors.lastname: Sharma
authors.forename: John
authors.initials: J
authors.lastname: Bera
authors.forename: Prakash
authors.initials: P
authors.lastname: Kotwal
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006365:Heel; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D062707:Return to Work; D014057:Tomography, X-Ray Computed; D014945:Wound Healing