Long-term mortality after internal fixation of calcaneal fractures: a retrospective study

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Epidemiology

Background:

• Calcaneal fractures are severe injuries often requiring surgical intervention.
• Understanding mortality risk and predictors after operative fixation is crucial for patient management.
• Previous studies have not fully elucidated long-term survival outcomes for this specific patient group.

Purpose of the Study:

• To describe the mortality risk associated with calcaneal fractures treated with internal fixation.
• To identify predictors of survival in patients undergoing operative fixation for displaced intra-articular calcaneal fractures.
• To compare the mortality risk in this patient cohort to the general population.

Main Methods:

• Retrospective cohort study of 178 patients undergoing operative fixation for calcaneal fractures between 1995 and 2006.
• Data collected included patient demographics, injury mechanism, and social deprivation (Carstairs index).
• Mortality data and causes of death were obtained from patient records and national databases; standardized mortality ratios (SMRs) were calculated.

Main Results:

• Twenty-eight deaths occurred among 168 patients with follow-up data.
• Overall 10-year survival was 92.8% and 15-year survival was 81.9%.
• Male gender was a significant predictor of mortality (Hazard Ratio 2.77, p=0.01), even after adjusting for age and social deprivation. The 10-year SMR was 5.2 for males and 1.4 for females.

Conclusions:

• Male patients undergoing internal fixation for intra-articular calcaneal fractures exhibit a significantly elevated mortality risk compared to the general population.
• Further research is needed to determine the underlying causes of this increased mortality.
• Identifying reasons for increased mortality may lead to improved survival strategies for these patients.