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. 2008 Oct;32(5):711-5.
doi: 10.1007/s00264-007-0385-y. Epub 2007 Jun 13.

Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey

T Schepers  1 , E M M van Lieshout, T M van Ginhoven, M J Heetveld, P Patka
Affiliations

Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey

T Schepers et al. Int Orthop. 2008 Oct.

Abstract
in English, French

The treatment of intra-articular calcaneal fractures is controversial and randomised clinical trials are scarce. Moreover, the socio-economic cost remains unclear. The aim of this study was to estimate the incidence, treatment preferences and socio-economic cost of this complex fracture in the Netherlands. This data may aid in planning future clinical trials and support education. The method of study was of a cross-sectional survey design. A written survey was sent to one representative of both the traumatology and the orthopaedic staff in each hospital in the Netherlands. Data on incidence, treatment modalities, complications and follow-up strategies were recorded. The socio-economic cost was calculated. The average response rate was 70%. Fracture classifications, mostly by Sanders and Essex-Lopresti, were applied by 29%. Annually, 920 intra-articular calcaneal fractures (0.4% incidence rate) were treated, mainly with ORIF (46%), conservative (39%) and percutaneous (10%) treatment. The average non-weight-bearing mobilisation was 9 weeks (SD 2 weeks). An outcome score, mainly AOFAS, was documented by 7%. A secondary arthrodesis was performed in 21% of patients. The socio-economic cost was estimated to be euro21.5-30.7 million. Dutch intra-articular calcaneal fracture incidence is at least 0.4% of all fractures presenting to hospitals. Better insight into treatment modalities currently employed and costs in the Netherlands was obtained.

Le traitement des fractures articulaires du calcanéum reste controversé. Par ailleurs les aspects de coûts d’évaluation socio-économique ne sont pas très clairement connus. Le but de cette étude est d’évaluer leur incidence et d’envisager le meilleur traitement ainsi que les répercutions économiques de cette fracture complexe aux Pays-Bas. Un modèle d’étude a été envoyé à chaque responsable de service d’orthopédie traumatologie de chaque hôpital des Pays-Bas avec une évaluation de données comportant des modalités thérapeutiques, des complications, de suivi, de même que coûts socio-économiques. Résultats : le taux de réponse a été de 70%. Les fractures ont été classées selon Sanders et Essex-Lopresti dans 29% des cas. 920 fractures articulaires du calcanéum ont été traitées en une année (0.4%), plus souvent avec ostéosynthèse interne (46%), traitement conservateur (39%), ou percutané (10%). En moyenne, la reprise d’appui a été de 9 semaines. L’évaluation des résultats a été documentée dans 7% des cas selon le score AOFAS. Une arthrodèse secondaire a été réalisée chez 21% des patients et le coût socio-économique était estimé de 21.5 à 30.7 millions d’euros. En conclusion : l’incidence des fractures articulaires du calcanéum au Pays-Bas est d’au moins 0.4%. De toutes les fractures traitées dans tous les hôpitaux néerlandais nous avons pu ainsi obtenir les éléments de ces fractures ainsi que leurs coûts.

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Figures

Fig. 1
Fig. 1
Response rates and the number of patients treated using the three most frequently applied modalities per province in the Netherlands. R=response rate in percentage; C=absolute number of patients treated conservatively; O=absolute number of patients treated using ORIF; P=absolute number of patients treated percutaneously, as described by Forgon and Zadravecz
See this image and copyright information in PMC

References

    1. AO Publishing Intraarticular calcaneal fractures; operative management. Orthop Trauma Dir. 2004;2:9–16.
    1. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–1136. doi: 10.1016/S0895-4356(97)00126-1. - DOI - PubMed
    1. Atkins RM, Allen PE, Livingstone JA. Demographic features of intra-articular fractures of the calcaneum. Foot Ankle Surg. 2001;7:77–84. doi: 10.1046/j.1460-9584.2001.00242.x. - DOI
    1. Bajammal S, Tornetta P, 3rd, Sanders D, Bhandari M. Displaced intra-articular calcaneal fractures. J Orthop Trauma. 2005;19:360–364. - PubMed
    1. Barei DP, Bellabarba C, Sangeorzan BJ, Benirschke SK. Fractures of the calcaneus. Orthop Clin North Am. 2002;33:263–285. doi: 10.1016/S0030-5898(03)00084-1. - DOI - PubMed