Age, gender, work capability, and worker's compensation in patients with displaced intraarticular calcaneal fractures

Objectives: To determine which demographic variables are linked with outcom e in displaced intraarticular calcaneal fractures. The variables studied we re age, gender, work capability, Workers' Compensation Board (WCB) support, and injury type. Design: A prospective cohort study with a minimum of two years of follow-up . Setting: A university-affiliated Level I trauma hospital. Patients: One hundred sixty-nine patients who required treatment for displa ced intraarticular calcaneal fractures treated by a single surgeon. To be i ncluded in the study, patients had to be aged between fifteen and sixty-fiv e years at the time of the injury, have closed injuries, and have posterior facet displacement greater than two millimeters. Intervention: Patients: were treated nonoperatively or operatively, using a lateral approach to the calcaneus. Main Outcome Measurements: Outcome was measured by return of patients to fu ll-time work, change in work capability after treatment, the SF-36 health s urvey, and visual analog scales. Results: Male gender, medium and heavy labor, presence of WCB support, and presence of bilateral intraarticular fractures all proved to be associated with a poorer prognosis. Female patients did well when treated nonoperative ly and operatively, whereas male patients always were less able to return t o work at the same level as before the injury. Operatively treated patients returned to work quicker (average, eighty-seven days). Conclusions: Males, multiply injured patients, and heavy laborers may have better outcomes with operative treatment, whereas females and non-WCB patie nts may do better with nonoperative treatment.