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Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial.

Griffin D, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, Lamb SE, UK Heel Fracture Trial Investigato - BMJ (2014)

Bottom Line: There was no significant difference in the primary outcome (mean Kerr-Atkins score 69.8 in operative group v 65.7 in non-operative group; adjusted 95% confidence interval of difference -7.1 to 7.0) or in any of the secondary outcomes between treatment groups.Complications and reoperations were more common in those who received operative care (estimated odds ratio 7.5, 95% confidence interval 2.0 to 41.8).Operative treatment compared with non-operative care showed no symptomatic or functional advantage after two years in patients with typical displaced intra-articular fractures of the calcaneus, and the risk of complications was higher after surgery.

View Article: PubMed Central - PubMed

Affiliation: Warwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK damian.griffin@warwick.ac.uk.

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Fig 2 Kerr-Atkins scores for calcaneal fracture and 95% confidence intervals at baseline (before injury) and 6, 12, 18, and 24 months after injury for all participants and for those with type 2 and with type 3 or 4 fractures (Sanders classification)
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fig2: Fig 2 Kerr-Atkins scores for calcaneal fracture and 95% confidence intervals at baseline (before injury) and 6, 12, 18, and 24 months after injury for all participants and for those with type 2 and with type 3 or 4 fractures (Sanders classification)

Mentions: Kerr-Atkins scores improved for 18 months after injury and were then stable to the trial endpoint at two years for the full population as well as for subgroups with type 2 fractures and with type 3 and 4 fractures according to Sanders classification (fig 2). At two years, Kerr-Atkins scores were in the range 60-80 and still considerably lower than before injury, indicating moderate pain and changes to normal walking. This was confirmed by the SF-36 physical component scores, which were approximately 40 at two years, a level associated with longstanding physical illness.32


Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial.

Griffin D, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, Lamb SE, UK Heel Fracture Trial Investigato - BMJ (2014)

Fig 2 Kerr-Atkins scores for calcaneal fracture and 95% confidence intervals at baseline (before injury) and 6, 12, 18, and 24 months after injury for all participants and for those with type 2 and with type 3 or 4 fractures (Sanders classification)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109620&req=5

fig2: Fig 2 Kerr-Atkins scores for calcaneal fracture and 95% confidence intervals at baseline (before injury) and 6, 12, 18, and 24 months after injury for all participants and for those with type 2 and with type 3 or 4 fractures (Sanders classification)
Mentions: Kerr-Atkins scores improved for 18 months after injury and were then stable to the trial endpoint at two years for the full population as well as for subgroups with type 2 fractures and with type 3 and 4 fractures according to Sanders classification (fig 2). At two years, Kerr-Atkins scores were in the range 60-80 and still considerably lower than before injury, indicating moderate pain and changes to normal walking. This was confirmed by the SF-36 physical component scores, which were approximately 40 at two years, a level associated with longstanding physical illness.32

Bottom Line: There was no significant difference in the primary outcome (mean Kerr-Atkins score 69.8 in operative group v 65.7 in non-operative group; adjusted 95% confidence interval of difference -7.1 to 7.0) or in any of the secondary outcomes between treatment groups.Complications and reoperations were more common in those who received operative care (estimated odds ratio 7.5, 95% confidence interval 2.0 to 41.8).Operative treatment compared with non-operative care showed no symptomatic or functional advantage after two years in patients with typical displaced intra-articular fractures of the calcaneus, and the risk of complications was higher after surgery.

View Article: PubMed Central - PubMed

Affiliation: Warwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK damian.griffin@warwick.ac.uk.

Show MeSH
Related in: MedlinePlus