Comparison of non-operative and surgical treatment of displaced calcaneal fractures

BackgroundIn the literature controversy exists as to whether operative or non-operative treatment is better for intra-articular fractures of the calcaneum.ObjectiveTo assess if there was any difference in outcome between surgical and non-surgical intervention in displaced intra-articular fractures of the calcaneum.MethodFrom 2000 to 2005, 40 patients, with displaced calcaneal fractures were identified. After exclusion for co-morbidities and loss to follow-up, two groups of 14 patients with similar age, sex, length of follow-up, fracture type (Essex-Lopresti classification) were compared using the SF-36 questionnaire.ResultsAll eight SF-36 outcome scales showed highly significant differences favouring operative intervention when compared to the non-operative group. There was no significant difference between the surgical and non-surgical groups for age, sex, length of follow-up and fracture type.ConclusionThe authors acknowledge the numbers involved in this study are small but recommend internal fixation for displaced intra-articular calcaneal fractures.