• Georgios Alexandridis, Amy C Gunning, van Olden Ger D J GDJ Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands., Verleisdonk Egbert-Jan M M EMM Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands., Segers Michiel J M MJM Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands., and Leenen Luke P H LPH Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, Suite: G04.228, 3584 CX, Utrecht, The Netherlands..
• Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, Suite: G04.228, 3584 CX, Utrecht, The Netherlands. georgios.alexandridis@gmail.com.
• Int Orthop. 2018 Sep 1; 42 (9): 2231-2241.

PurposesCalcaneal fractures are known to influence patients' quality of life negatively. The type of calcaneal fracture might have a relation with the patient outcome. To inform patients in an early stage on how their calcaneal fracture may affect their lives, knowledge of the fracture characteristics is necessary. This study evaluates the association of type of calcaneal fracture, measurement of conventional radiograph angles, and the Sanders classification with patient-reported outcomes.Material And MethodsThis is a retrospective study based on a prospective trauma database including all patients aged 16 years or older with a calcaneal fracture admitted in one of the participating trauma level I or II hospitals. Patients, trauma, and fracture characteristics were collected. The conventional radiographs were evaluated in which type of fracture, and Böhler's, Gissane's, and calcaneal compression angles were determined. Also, the CT images were classified according to Sanders. In addition, displaced intra-articular calcaneal fractures were separately analyzed. A questionnaire was sent to the included patients that consisted of the EQ-6D, patient-specific characteristics, satisfaction with foot appearance and wearable shoe range, complications, and capability to work.ResultsA total of 396 patients with 442 calcaneal fractures were eligible for follow-up. Two hundred fifteen patients with 246 calcaneal fractures participated. Patients with a calcaneal fracture into the talar surface reported a worse quality of life (p = 0.010), were less satisfied with their feet (p < 0.001), and had more complications (p = 0.001-0.006); extra-articular fractures had significantly opposite result. A negative Böhler's or calcaneal compression angle was related with unfavourable outcomes. Sanders classification was not related with any patient-reported outcome.ConclusionOur study implies that patients with an intra-articular calcaneal fracture into the talar surface have a lower health-related quality of life, will be less satisfied with the outcome of their feet, and have more complications compared to patients with other type of calcaneal fractures. Furthermore, the Sanders classification was not associated with the patient-reported outcomes.

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