Document Detail


Operative vs. nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial.
MedLine Citation:
PMID:  8821279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thirty patients with displaced, intra-articular calcaneus fractures were randomized to operative or nonoperative treatment. All patients had two or three major articular fragments of the posterior facet (Sanders type II or III). Nonoperative treatment included early mobilization and delayed weightbearing. Operative treatment involved open reduction and rigid internal fixation with a plate and screws through an extensile, L-shaped lateral approach followed by early mobilization and delayed weightbearing. Fifteen operative patients were evaluated at an average of 17 months follow-up and 11 nonoperative patients were seen at 14 months average follow-up. In the operative group, there were 7 excellent results, 5 good results, 2 fair results, and 1 poor result, and in the nonoperative group there was 1 excellent result, 3 good results, 1 fair result, and 6 poor results (difference significant as P < 0.01). A functional scoring system of 0-100 points was developed based upon the responses to an outcome assessment questionnaire. The average functional score for the operative group was far superior at 86.7, compared with 55.0 for the nonoperative group (P < 0.0001). Subtalar range of motion averaged 20 degrees for the operative group and 17 degrees for the nonoperative group with pain on extremes of motion of 25% of the operative patients compared with 100% of the nonoperative patients. This study is the first prospective, randomized trial to demonstrate the superior results of current operative treatment with early mobilization compared with nonoperative treatment.
Authors:
D B Thordarson; L E Krieger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Foot & ankle international     Volume:  17     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-11-27     Completed Date:  1996-11-27     Revised Date:  2014-08-27    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Plates
Bone Screws
Calcaneus / injuries*,  radiography,  surgery
Dislocations / radiography,  surgery,  therapy*
Early Ambulation
Female
Fracture Fixation, Internal / methods
Fractures, Closed / radiography,  surgery,  therapy*
Humans
Male
Middle Aged
Prospective Studies
Weight-Bearing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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