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Review Question - QID 1054

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QID 1054 (Type "1054" in App Search)
A 42-year-old male sustains the closed injury shown in Figure A. Which of the following factors is associated with improved outcomes with open reduction and internal fixation?
  • A

Age > 40

2%

26/1726

Smoking

1%

13/1726

Male sex

5%

82/1726

No worker's compensation involvement

91%

1575/1726

Career as construction worker

2%

26/1726

  • A

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The clinical and radiographic presentation is consistent with a closed, displaced, comminuted calcaneus fracture. Non-worker's compensation patients have improved outcomes with operative treatment.

Buckley et al performed a multicenter prospective randomized study of over 300 displaced calcaneus fractures comparing nonoperative vs. operative treatment. They looked at patient satisfaction, SF-36 scores, and Bohler’s angle. They showed improved outcome in at least one measure after an operation vs. no operation for intraarticular calcaneal fractures in: 1) Women 2) Age <30 3) Non Smokers 4) Light work laborers 5) Non worker’s compensation patients.

Sanders et al reviews calcaneus fractures, including treatment techniques. They recommend getting two-dimensional computed tomographic scans in both the coronal and the transverse plane. They report with operative treatment, the goal is restoring not only articular congruency, but also the shape and alignment of the calcaneus.

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