Operative vs nonoperative treatment of intra-articular fractures of the calcaneus: A prospective randomized trial

被引:272
作者
Thordarson, DB
Krieger, LE
机构
[1] Department of Orthopaedics, University of Southern California, Los Angeles, CA 90033, 1200 North State St.
关键词
D O I
10.1177/107110079601700102
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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 at 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.
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页码:2 / 9
页数:8
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