Aim:  To determine whether internal fixation & open reduction are superior to non-operative treatment for displaced intra-articular calcaneal fractures.  

Study Design: Randomized controlled trial

Place and duration: This study was conducted at Muhammad Medical College and Hospital Mirpurkhas, Pakistan from 2019 and 2020

Methodology: Patients' Kerr-Atkins scores for pain and function at two years following injury were used as the main outcome measure in this study. Complications, hindfoot discomfort and function general health, life ‘quality, clinical examination, walking speed, & symmetry of gait were all considered secondary outcomes. A treatment-oriented approach to analysis was used.

Results: Total 151 patients were taken for this study. There were 95 percent follow-ups for the primary outcome (69 for patients who had surgery and 74 for those who had not), and 75 percent of patients fulfilled all secondary goals. There was no statistical difference in the primary outcome or any of the secondary outcomes between the both groups. Patients who had surgery experienced greater problems and needed additional surgeries

Conclusions: Two years following surgery, individuals with a typical displaced intra-articular calcaneus fracture exhibited no clinical or functional improvement, and the risk of comorbidities rose. Open reduction plus internal fixation for these fractures is not suggested based on these results.

Keywords: Displaced intra-articular calcaneus fractures, Operative management, Nonoperative management