To bear weight or not in operatively treated displaced intra-articular calcaneal fractures: Interim analysis of a multicenter study

Abstract text (incl. references and figure legends)

I: Displaced intra-articular calcaneal fractures (DIACFs) are debilitating injuries. Even after operative treatment, rehabilitation requires months to years(1-3). Only a few regain their pre-injury level of function(4). The aim was to assess whether early postoperative permissive weight-bearing (PWB) results in improved functional outcomes (FO) and higher quality of life (QoL) at a minimum of 2y follow-up (FU), compared to a non-weightbearing protocol (NWB)(5).

M&M: Patients with an DIACF, operatively treated from 2015-2020. FO evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Maryland Foot Score (MFS) (6,7). General health and QoL assessed using the Short Form-12 (SF-12) and EQ-5D(8-10).

R: The inclusion will be finished in November 2022. This interim analysis contains 23 patients. 16 patients rehabilitated following the NWB-, 7 with the PWB-protocol. No differences in baseline characteristics were found. Compared to the NWB-, the PWB-group has significant higher FO scores on AOFAS (83.8 vs. 63.5) and MFS (83.2 vs. 72.7, not significant). No differences were found in SF-12 and EQ-5D. All patients in the PWB-group could return to previous sports vs. 50% in the NWB-group.

C: The interim results of this multicenter study may indicate that, after a minimum of 2y of FU, the PWB- yields higher FO compared to the NWB-group. The PWB-group was twice as likely to resume their pre-injury sport activities. Further research is needed to assess the general QoL, the effect of PWB on posttraumatic arthritis, the potential positive effects for the different Sanders classification subgroups(11).

Ref. (1st author)

Brauer 2005. JBJS Rammelt 2018 Indian J Orthop. Schepers 2008. Int Orthop. Ditshuizen 2021. Eur J Trauma Emerg Surg. Meys 2019Journal of Rehabilitation Med. Lieshout 2017. BMJ Myerson 1986 Foot Ankle Versteegh 2016. Value Health Ware 1996. Med Care Kiely 2006. Journal of Surgical Research Sanders 1993. Clinical Orthop. & Related Research

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