Operative compared to non-operative treatment of displaced intra-articular calcaneal fractures

BACKGROUND: The aim of this study was to compare outcomes of open reduction and rigid internal fixation of displaced calcaneal fractures with that of non operative treatment. METHODS: Seventy two consecutive patients with displaced intra-articular calcaneal fractures were selected regarding inclusive and exclusive criteria and then were randomly allocated to surgical and non surgical groups. First group underwent open reduction and internal fixation with reconstruction plate and screws fixation and the other group were treated with closed reduction and cast immobilization. Data were collected by clinical observation and a check list. Data was analyzed by chi-square and student's t-test. RESULTS: The results showed significant difference between outcomes of surgical treatment and nonsurgical method (p = 0.001). There were some differences between two methods in terms of decreasing pain [Odd Ratio (OR): 6.72, p = 0.001], swelling (OR: 6.80, p = 0.001), increased range of motion of the joints (p = 0.001), decreased late osteoarthritis (OR: 2.33, p = 0.22) in favor of surgical group. CONCLUSIONS: Open reduction and internal fixation of displaced calcaneal fractures in absence of open fracture, severe osteoporosis, or comminution, poor general condition may be the preferred method of treatment.