• Felix Marius Bläsius, Laura Elisabeth Stockem, Matthias Knobe, Hagen Andruszkow, Frank Hildebrand, and Philipp Lichte.
• Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. fblaesius@ukaachen.de.
• Eur J Trauma Emerg Surg. 2022 Aug 1; 48 (4): 3157-3163.

PurposeSurgically treated calcaneal fractures have a high risk of postoperative wound healing complications and a prolonged length of hospital stay (LOS). The aim of this study was to identify predictor variables of impaired wound healing (IWH) and LOS in surgically treated patients with isolated calcaneal fractures.MethodsThis retrospective cohort study analyzed data on patients aged 18 years or older who were admitted to a level I trauma center with isolated calcaneal fractures between 2008 and 2018. Multivariable regression models were used to identify predictor variables.ResultsIn total, 89 patients (age: 45.4 years; SD: 15.1) were included. In 68 of these patients, low-profile locking plate osteosynthesis was performed, and a minimally invasive approach (MIA) (percutaneous single screws/K-wire or low-profile locking plating via a sinus tarsi approach) was applied in 21 patients. Multivariable regression analysis revealed that a higher preoperative Böhler's angle (β = - 0.16 days/degree, 95% CI [- 0.25, - 0.08], p = 0.004) and MIA (β = - 5.04 days, 95% CI [- 8.52, - 1.56], p = 0.002) reduced the LOS. A longer time-to-surgery (β = 1.04 days/days, 95% CI [0.66, 1.42] p = 0.001) and IWH increased the LOS (β = 7.80 days, 95% CI [4.48, 11.12], p = 0.008). In a subsequent multivariable regression analysis, two variables, open fractures (OR: 14.6, 95% CI [1.19, 180.2], p = 0.030) and overweight (BMI > 24) (OR: 3.65, 95% CI [1.11, 12.00], p = 0.019), increased the risk of IWH.ConclusionAdvanced treatment algorithms for open fractures are needed to reduce the risk of IWH.© 2022. The Author(s).

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