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Displaced intra-articular calcaneal fractures: 15-Year follow-up of a randomised controlled trial of conservative versus operative treatment

2007; Elsevier BV; Volume: 38; Issue: 7 Linguagem: Inglês

10.1016/j.injury.2007.01.003

1879-0267

Talal Ibrahim, M. Rowsell, Winston J. Rennie, Andrew Brown, Gordon Taylor, P. J. Gregg,

Tendon Structure and Treatment

Summary Aim To report the 15-year follow-up of displaced intra-articular calcaneal fractures from a randomised controlled trial of conservative versus operative treatment published in 1993. Patients and methods Of the initial study, 46 patients (82%) were still alive at a mean of 15 years post injury and 26 patients (57%) agreed to review. The patients had been randomly allocated to either conservative or operative treatment in the original study. Clinical [American orthopaedic foot and ankle society hindfoot scale (AOFAS), foot function index (FFI) and calcaneal fracture score] and radiological (Böhler's angle and calcaneum height) outcome measures were used. The grade of osteoarthritis was also assessed at long-term follow-up. Results At long-term follow-up, the clinical outcomes were not different between conservative versus operative treatment. AOFAS hindfoot scale: conservative=78.5 and operative=70, p =0.11; FFI: conservative=24.4 and operative=26.9, p =0.66; calcaneal fracture score: conservative=70.1 and operative=63.5, p =0.41. The radiological outcomes were also not different between both groups. Böhler's angle: conservative=10.4° and operative 16.9°, p =0.07; height of calcaneum: conservative=37.2mm and operative=38.2mm, p =0.57; grade of osteoarthritis of the sub-talar joint: p =0.54. There was no correlation between Böhler's angle and the outcome measures in either group. Conclusion The results of this 15-year follow-up of displaced intra-articular calcaneal fracture randomised controlled trial were equivalent between conservative and operative treatment and demonstrate similar findings to those at one year follow-up.