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Ir J Med Sci. 2002 Jul-Sep;171(3):155-7.

Outcome of calcaneal fractures treated operatively and non-operatively. the effect of litigation on outcomes.

Author information

1
Department of Orthopaedic Surgery, Waterford Regional Hospital, Ireland. brianthornes@esatclear.ie

Abstract

BACKGROUND:

The optimum management of calcaneal fractures is controversial. These injuries are frequently associated with compensation litigation, which effects the outcome.

AIMS:

To assess the outcome of operatively and conservatively managed intra-articular calcaneal fractures and to examine the effect of compensation litigation on outcome.

METHODS:

This was a retrospective study of calcaneal fractures from a single regional trauma unit, with management decided by the admitting consultant surgeon's preference. Fifty-four patients (33 operative, 21 conservative) with an average follow-up of 40 months (range 14-78 months) were reviewed. Sixteen patients (30%) were pursuing a compensation case resulting from the injury.

RESULTS:

Despite similar fractures, medical co-morbidity and trauma energy, significantly worse outcome scores were seen in litigants (p < 0.0001). Footwear fitting problems were greater in litigants. Time off work was more than twice that of non-litigants (14.5 vs 6 months, p < 0.01). Results were similar between the operative and non-operative groups in terms of functional score, footwear problems and time off work.

CONCLUSIONS:

Litigation was the major determinant of outcome following calcaneal fracture repair; highlighting the unreliability of subjective evaluation in determining outcome in the face of litigation. No subset of patients appeared to significantly benefit from internal fixation of their fracture.

PMID:
15736356
[Indexed for MEDLINE]

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