Verstappen Coen, Kalmet Pishtiwan H S, Maduro Cherelle V, VAN Vugt Raoul, Sintenie Jan Bernard, VAN DER Veen Alexander, Edwards Michael J R, Poeze Martijn, Hermans Erik, Driessen Mitchell L S
Department of Trauma Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands.
Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
J Rehabil Med Clin Commun. 2025 Apr 7;8:42747. doi: 10.2340/jrm-cc.v8.42747. eCollection 2025.
The current aftertreatment for surgically treated patients with displaced intra-articular calcaneal fractures (DIACFs) consists of restricted weight bearing (RWB) for 8-12 weeks. This study aimed to assess whether permissive weight bearing (PWB) results in improved patient-reported outcomes (PROMs) after a minimum of 2 years follow-up, compared to RWB.
Multicentre, retrospective cohort study.
Surgically treated patients with isolated unilateral DIACFs.
Foot and ankle function was measured using the American Orthopaedic Foot and Ankle Society (AOFAS) Score and the Maryland Foot Score (MFS). Health-related quality of life was assessed using the Short Form-12 (SF-12) and the EuroQoL EQ-5D-5L (EQ-5D). Additionally, radiographic parameters and complications were recorded.
Fourteen patients followed the PWB and 18 followed the RWB protocol ( = 32). The PWB group had similar outcome scores on the AOFAS Score (83.4 vs. 71.1, = 0.13) and MFS (86.3 vs. 77.6, = 0.20) compared to the RWB group. PWB showed similar outcomes on the EQ-5D (0.86 vs. 0.80, = 0.26) scores. Radiographic parameters and complication rates were comparable for both groups.
This study suggests that PWB and RWB yield comparable PROMs in foot and ankle function without radiographic failures and similar complication rates in surgically treated patients with isolated, unilateral DIACFs.
目前，手术治疗的移位性关节内跟骨骨折（DIACF）患者的术后治疗包括8至12周的限制负重（RWB）。本研究旨在评估与RWB相比，允许负重（PWB）在至少2年的随访后是否能改善患者报告的结局（PROMs）。
多中心回顾性队列研究。
接受手术治疗的孤立性单侧DIACF患者。
使用美国矫形足踝协会（AOFAS）评分和马里兰足部评分（MFS）测量足踝功能。使用简短健康调查问卷12项版（SF-12）和欧洲五维健康量表（EQ-5D-5L，EQ-5D）评估健康相关生活质量。此外，记录影像学参数和并发症。
14例患者采用PWB方案，18例采用RWB方案（n = 32）。与RWB组相比，PWB组在AOFAS评分（83.4对71.1，P = 0.13）和MFS（86.3对77.6，P = 0.20）上的结局评分相似。PWB组在EQ-5D评分上也有相似的结果（0.86对0.80，P = 0.26）。两组的影像学参数和并发症发生率相当。
本研究表明，在接受手术治疗的孤立性单侧DIACF患者中，PWB和RWB在足踝功能方面产生的PROMs相当，无影像学失败且并发症发生率相似。
