AIM: To report the 15-year follow-up of displaced intra-articular calcaneal fractures from a randomised controlled trial of conservative versus operative treatment published in 1993. PATIENTS AND METHODS: Of the initial study, 46 patients (82%) were still alive at a mean of 15 years post injury and 26 patients (57%) agreed to review. The patients had been randomly allocated to either conservative or operative treatment in the original study. Clinical (American orthopaedic foot and ankle society hindfoot scale (AOFAS), foot function index (FFI) and calcaneal fracture score) and radiological (Bohler's angle and calcaneum height) outcome measures were used. The grade of osteoarthritis was also assessed at long-term follow-up. RESULTS: At long-term follow-up, the clinical outcomes were not different between conservative versus operative treatment. AOFAS hindfoot scale conservative 78.5 and operative 70, p = 0.11; FFI conservative 24.4 and operative 26.9, p = 0.66; calcaneal fracture score conservative 70.1 and operative 63.5, p = 0.41. The radiological outcomes were also not different between both groups. Bohler's angle conservative 10.4 degrees and operative 16.9 degrees, p = 0.07; height of calcaneum conservative 37.2mm and operative 38.2mm, p = 0.57; grade of osteoarthritis of the sub-talar joint p = 0.54. There was no correlation between Bohler's angle and the outcome measures in either group. CONCLUSION: The results of this 15-year follow-up of displaced intra-articular calcaneal fracture randomised controlled trial were equivalent between conservative and operative treatment and demonstrate similar findings to those at one year follow-up.
With permission from Excerpta Medica Inc.

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