Open Reduction and Internal Fixation Compared With ORIF and Primary Subtalar Arthrodesis for Treatment of Sanders Type IV Calcaneal Fractures

• DOI: 10.1097/bot.0000000000000191
• Publication Date: 2014-07-02T02:54:18Z
• Authors: Richard Buckley; Ross Leighton; David Sanders; Jeffrey Poon; Chad P. Coles; David Stephen; Elizabeth O. Paol...
• Keywords: Subtalar joint; Calcaneal fracture

To compare long-term health outcome of Sanders type IV calcaneal fractures treated with open reduction and internal fixation (ORIF) versus ORIF plus primary subtalar arthrodesis (PSTA).Randomized prospective multicenter trial.Four Level 1 trauma hospitals in Canada.Thirty-one patients 31 displaced intraarticular fractures.Seventeen were a standard protocol involving lateral approach for ORIF. Fourteen + PSTA.Health outcomes assessed 4 validated instruments: (1) the Short Form 36 version 2 (SF-36), (2) Musculoskeletal Functional Assessment Survey, (3) American Orthopaedic Foot Ankle Society's Ankle-Hindfoot Scale, (4) Visual Analogue Scale.From 2004 to 2011, 26 (26 fractures) followed minimum years (81% follow-up). No statistical difference was found between results compared PSTA: mean SF-36 physical component scores were, respectively, 30.2 (SD = 11.4) 37.8 10.4) (P 0.10); Survey 44.2 25.6) 37.9 21.5) 0.50); Scale 62.5 19.6) 65.8 19.2), 0.68); 36.8 34.7) 36.0 30.7) 0.82).We unable demonstrate significant treating either or PSTA. It remains choice surgeon patient take into account specific factors determine treatment. However, PSTA may be advantageous both care system as heal quickly. Furthermore, prevent need late secondary fusion adding increased costs lost time from work.Therapeutic II. See Instructions Authors complete description levels evidence.