Evidence map›Paper›PMID 25059747›Full record

Trial reportBMJ (Clinical research ed.)2014

Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial.

Damian Griffin, Nick Parsons, Ewart Shaw, Yuri Kulikov, Charles Hutchinson, Margaret Thorogood, Sarah E Lamb, UK Heel Fracture Trial Investigators

Registry-linked trialOpen access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02609347 (Immediate Effects of Manual Therapy for Patients After Ankle/Hindfoot Fractures), which is not on this map. Cited by 104 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 14 pooled it
19.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02609347 nacompletednot on this mapstarted 2015, after this paper: background citation

Immediate Effects of Manual Therapy for Patients After Ankle/Hindfoot Fractures

TypeinterventionalSponsorIntermountain Health Care, Inc.Ran2015 to 2019Enrolled72ConditionsAnkle Fracture, Calcaneus Fracture, Talus Fracture, Pilon FractureArmsManual Therapy Group, Control Group
3 · Its place in the literature

Who cites it

104 citing papers in PubMed, 14 syntheses or guidelines pooled it, 300 citations in OpenAlex.

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  4. A review of trauma and orthopaedic randomised clinical trials published in high-impact general medical journals.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022
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  16. Percutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations - a biomechanical human cadaveric analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
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44 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Damian GriffinWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK damian.griffin@warwick.ac.uk.
Nick ParsonsWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
Ewart ShawWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
Yuri KulikovWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
Charles HutchinsonWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
Margaret ThorogoodWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
Sarah E LambWarwick Medical School and Department of Statistics, University of Warwick, and University Hospital of Coventry and Warwickshire NHS Trust, Coventry, UK.
UK Heel Fracture Trial Investigators
University of Warwick · GBUniversity Hospital Coventry · GB

Funding

Arthritis Research UK 15964Versus Arthritis 15964
6 · The paper itself

Abstract

objectiveTo investigate whether surgery by open reduction and internal fixation provides benefit compared with non-operative treatment for displaced, intra-articular calcaneal fractures.

designPragmatic, multicentre, two arm, parallel group, assessor blinded randomised controlled trial (UK Heel Fracture Trial).

setting22 tertiary referral hospitals, United Kingdom.

participants151 patients with acute displaced intra-articular calcaneal fractures randomly allocated to operative (n=73) or non-operative (n=78) treatment.

main outcome measuresThe primary outcome measure was patient reported Kerr-Atkins score for pain and function (scale 0-100, 100 being the best possible score) at two years after injury. Secondary outcomes were complications; hindfoot pain and function (American Orthopaedic Foot and Ankle Society score); general health (SF-36); quality of life (EQ-5D); clinical examination; walking speed; and gait symmetry. Analysis was by intention to treat.

results95% follow-up was achieved for the primary outcome (69 in operative group and 74 in non-operative group), and a complete set of secondary outcomes were available for 75% of participants. There was no significant difference in the primary outcome (mean Kerr-Atkins score 69.8 in operative group v 65.7 in non-operative group; adjusted 95% confidence interval of difference -7.1 to 7.0) or in any of the secondary outcomes between treatment groups. Complications and reoperations were more common in those who received operative care (estimated odds ratio 7.5, 95% confidence interval 2.0 to 41.8).

conclusionsOperative treatment compared with non-operative care showed no symptomatic or functional advantage after two years in patients with typical displaced intra-articular fractures of the calcaneus, and the risk of complications was higher after surgery. Based on these findings, operative treatment by open reduction and internal fixation is not recommended for these fractures.Trial registration Current Controlled Trials ISRCTN37188541.

Indexed as

AdolescentAdultAgedAged, 80 and overCalcaneusFemaleFracture FixationFracture Fixation, InternalFractures, BoneFractures, ClosedHumansIntra-Articular FracturesMaleMiddle AgedPatient CompliancePhysical Therapy Modalities

Identifiers

PMID25059747
PMCPMC4109620
OpenAlexW2018390346

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.