Comparative analysis of functional outcome between operative and conservative treatment for closed, displaced, intra- articular fractures of the Calcaneum, a randomized study

Abstract

Background: Calcaneum fracture is one of the more common fractures causing significant morbidity to the patients, so debate continues for choice of management of calcaneal fractures, between operative and conservative management. The aim of this study was to compare the outcomes of operative management and conservative management in closed, displaced, intra- articular fractures of the calcaneum. Materials and Methods: Thirty patients with thirty-two displaced intra-articular calcaneal fractures were selected during July 2019 to June 2020 with taking inclusive and exclusive criteria into consideration and randomly divided into surgical and non-surgical groups. First group of patients was managed with operative technique. Patients in other group were treated with closed reduction and cast immobilization using the Omoto technique. The observations in both the groups were compared and analysed. Results: The difference between the outcomes of surgical treatment and nonsurgical methods that were significant were noted. The fracture union occurred between 12 -16 weeks and no case of non-union has been reported. Some of the patients had reported with wound related complications and were managed with higher antibiotics and regular antiseptic dressings. The functional assessment of patients during follow ups has indicated that 87.6% patients of the operated group has good to excellent outcomes while 87.55% of conservatively managed patients have good to fair outcome. Conclusion: Operative management for closed displaced, intra- articular calcaneal fractures in absence of high grade osteoporosis, fracture comminution, and associated morbidity may be the preferred method of treatment.