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Psychological dysfunction associated with calcaneal fractures.

Tom P Walsh1, Varun Vasudeva2, Kevin Sampang2

  • 1Queensland University of Technology (QUT), Faculty of Health, School of Clinical Sciences, Kelvin Grove, Queensland 4059, Australia.

Injury
|June 1, 2021
PubMed
Summary

Calcaneal fractures, often from high falls, are linked to psychological health issues more than ankle fractures. Patients with calcaneal fractures are twice as likely to have pre-existing mental health conditions.

Keywords:
Ankle fracturesBone fractureCalcaneusMental health

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Area of Science:

  • Orthopaedic Surgery
  • Trauma Medicine
  • Psychological Health

Background:

  • The calcaneus is the most frequently fractured bone in the hindfoot, comprising over 60% of all tarsal fractures.
  • Understanding injury mechanisms and psychological factors is crucial for effective patient management.

Purpose of the Study:

  • To compare the mechanisms of injury and psychological health status of patients with calcaneal fractures against a matched control group with ankle fractures.
  • To identify potential correlations between fracture type and underlying psychopathology.

Main Methods:

  • Retrospective chart review of patients with calcaneal and ankle fractures at a tertiary hospital.
  • Age- and sex-matched comparison between the two fracture groups.
  • Statistical analysis including Mann-Whitney U test, Fisher's exact test, and multivariable binary logistic regression.

Main Results:

  • Calcaneal fractures were more commonly caused by high-energy falls (over one meter) compared to ankle fractures (51.2% vs. 26.0%).
  • Patients with calcaneal fractures showed a higher prevalence of diagnosed psychological health complaints (29.3% vs. 14.9%) and suicidal ideation (6.5% vs. 1.4%).
  • Premorbid psychopathology was significantly associated with calcaneal fractures, even after adjusting for injury mechanism (OR 2.20).

Conclusions:

  • Significant differences exist in injury mechanisms and psychological health histories between calcaneal and ankle fracture patients.
  • Premorbid psychopathology is a key independent risk factor for calcaneal fractures.
  • Orthopaedic surgeons should consider psychological health assessments for patients with calcaneal fractures.