Evaluation of Bohler Angle, SF-36, and VAS Score in Operative vs Nonoperative Treatment of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis

Abstract

Introduction: In the management of displaced intraarticular calcaneus fractures, there are two options available: operative or nonoperative treatment. To establish a consensus, a number of randomized and case-controlled trials have been conducted. The aim of this analysis is to utilize the most reliable clinical evidence to provide recommendations for the optimal management of these injuries. Method: Using predetermined criteria, the authors conducted a search to identify relevant studies. After reaching a consensus among the authors, only prospective and randomized clinical trials were included. The methodological quality of the selected literature was evaluated using the Cochrane collaboration tool for randomized controlled trials (RCTs) and the Newcastle Ottawa Score for prospective trials. The outcome measures included the Bohler angle, the SF-36, and the score on the visual analog scale. The significance level was set to.05 and the confidence intervals (CIs) were set to 95% using the RevMan, version 5.4 software. Result: Our analysis included 4 studies, in which 4 randomized controlled trials (RCTs) with a total of 662 patients were included. The results indicated that the operative group demonstrated superior clinical outcomes in terms of VAS score, Bohler Angle, and SF-36. Nevertheless, there were no statistically significant differences between the efficacy of operative and non-operative treatments in regards to VAS score, Bohler angle, and SF-36. Conclusion: The current evidence suggests that operative treatment offers an advantage over non-operative treatment. It is important for patients to be informed that the available data supports better outcomes with operative treatment. However, in the case of older patients with low activity demands, there may not be a significant difference in outcomes between operative and non-operative treatment. Keywords: Operative, Non-operative, Intra-articular, Calcaneal, Fracture