Should calcaneal fractures be treated surgically? A meta-analysis

Area of Science:

• Orthopedic surgery
• Traumatology
• Evidence-based medicine

Background:

• Calcaneal fractures are common injuries.
• Treatment options include operative and nonoperative approaches.
• Optimal management for displaced calcaneal fractures remains debated.

Purpose of the Study:

• To systematically review and meta-analyze existing literature comparing operative versus nonoperative treatment for displaced calcaneal fractures.
• To assess the strength of evidence supporting surgical intervention.

Main Methods:

• A MEDLINE search identified 1845 articles on calcaneal fractures.
• Six studies met criteria for meta-analysis, comparing surgical and non-surgical treatments.
• Statistical summary focused on work return and foot pain outcomes.

Main Results:

• A trend suggested better return to work for surgically treated patients.
• Nonoperative treatment was associated with a higher risk of severe foot pain.
• Variability in reporting limited formal statistical summarization of other outcomes.

Conclusions:

• While trends favor operative treatment for displaced calcaneal fractures, the evidence strength is currently weak.
• Further high-quality research, such as prospective randomized controlled trials, is needed.
• Operative treatment may offer advantages in functional recovery and pain management.