Surgery to repair severe heel fractures ‘ineffective’

August 13, 2014, University of Warwick

(Medical Xpress)—Commonly-performed surgery to mend severe heel fractures is no more effective than non-surgical treatment, according to the results of an Arthritis Research UK-funded clinical trial.

Publishing their findings in the British Medical Journal, researchers at Warwick Medical School found that also led to painful and expensive complications, with 19 per cent of people who had surgery on their damaged heel joint developing an infection, and a further 11 per cent needing further surgery to remove infected or painful screws.

Severe heel injuries are suffered by about 2,000 people in the UK every year due to crushing and fracturing usually as a result of road accidents or falling off ladders. In the worst cases the injury leads to arthritis and a painful, deformed foot, and many have to walk with a walking stick and are unable to wear normal shoes. Some people never work again.

The trial, sponsored by the University of Warwick and the University Hospitals Coventry and Warwickshire NHS Trust, was one of the largest such randomised trials ever performed in , and involved 22 hospitals around the UK.

Study leader Damian Griffin, professor of trauma and orthopaedic surgery at Warwick Medical School said: "This study is likely to have a significant impact in the UK and around the world.

"For a clinical problem that has been beset by uncertainty for half a century, we believe that this study now provides clear evidence to guide practice. Future developments in surgical techniques to treat these fractures should be tested in before they are widely used."

The randomised controlled trial, which involved 150 patients who suffered a severe heel fracture, was conducted because of a long-standing lack of evidence as to whether surgical reconstruction was more effective than so-called conservative management of elevation, applying ice, and splinting.

Participants in both surgical and non-surgical treatment arms of the study recovered slowly, regardless of their treatment and reached a plateau of improvement at about 18 moths. After two years most were still adversely affected by their injury. About 85 per cent returned to work, although most changed to less physically demanding work, with no difference between the groups.

Writing in an accompanying editorial, Brigitte Scammell, professor of orthopaedic sciences at the University of Nottingham, added: "For most patients, surgery can no longer be justified. Conservative management is safer, but equally ineffective."

Explore further: Partial knee replacement safer than total knee replacement

Related Stories

Partial knee replacement safer than total knee replacement

July 7, 2014
Partial knee replacement surgery is safer than total knee replacement, according to a new study published in The Lancet today.

Possible advance for some late-stage lung cancer patients

July 7, 2014
(HealthDay)—Surgical biopsy is safe for certain late-stage lung cancer patients and could improve their chances of getting treated with newer types of drugs that target cancer-related genetic mutations, a new small study ...

Back surgery offers long-term societal benefits, according to new study

March 12, 2014
Annually, more than 10 million people experience back pain in the United States. More than 200,000 of these patients undergo surgery to alleviate pain due to a herniated disc. Surgery to remove the disc has been found to ...

Radiotherapy could spare bladder cancer patients surgery

October 1, 2013
Radiotherapy is an effective treatment for aggressive bladder cancer and could spare patients surgery that removes the whole bladder, according to a study published in this month's International Journal of Radiation Oncology ...

NICE to recommend 'single dose' radiotherapy during breast surgery

July 28, 2014
In new draft guidance, The National Institute for Health and Care excellence (NICE) is set to recommend a new form of radiotherapy for people with early stage breast cancer.

Recommended for you

Drug may help surgical patients stop opioids sooner

December 13, 2017
(HealthDay)—Opioid painkillers after surgery can be the first step toward addiction for some patients. But a common drug might cut the amount of narcotics that patients need, a new study finds.

Children best placed to explain facts of surgery to patients, say experts

December 13, 2017
Getting children to design patient information leaflets may improve patient understanding before they have surgery, finds an article in the Christmas issue of The BMJ.

Burn victim saved by skin grafts from identical twin (Update)

November 23, 2017
A man doomed to die after suffering burns across 95 percent of his body was saved by skin transplants from his identical twin in a world-first operation, French doctors said Thursday.

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.