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Male
71%
1837/2572
Works as an attorney
14%
371/2572
Nonsmoker
1%
27/2572
Twenty-seven years old
6%
153/2572
He was injured while off his job
167/2572
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The clinical presentation, radiographs, and CT are consistent with a displaced and severely depressed intra-articular calcaneus fracture. Rammelt et al reviews the operative treatment of calcaneal fractures. Notably poorer outcomes are associated with open fractures, delayed reduction after more than 14 days and individual risk factors such as high body mass index and smoking. The two studies by Buckley et al are both data taken from a multicenter, prospective, randomized study of calcaneal fractures. Women who were treated operatively achieved superior clinical outcomes compared to those women treated nonoperatively. Patients who were not on workers compensation and less than 29 years old and those that had a moderate Bohler's angle (0-14 degrees), less fracture comminution, more sedentary jobs, and an anatomic reduction reported superior clinical outcomes than those treated nonoperatively. Figure A is a lateral radiograph demonstrating an intra-articular joint depression calcaneus fracture. Figure B is a coronal CT scan demonstrating intra-articular displacement of the posterior facet. Answers 2-5 are all incorrect because these are predictive of superior outcome with operative treatment.
2.0
(53)
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