ArticleFoot & ankle orthopaedics2026
Early Full Weight-Bearing After Calcaneal Fracture Using a Heel-Unloader Orthosis: Equivalent Radiographic Outcomes Compared to Traditional Cast Treatment.
Article in Foot & ankle orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Standard treatment of calcaneal fractures involves prolonged immobilization with partial weight-bearing, risking ankle stiffness and lower-leg deconditioning. The heel-unloader enables early full weight-bearing by redirecting axial load from the hindfoot to the midfoot, forefoot, and lower leg. This study compares radiologic and clinical outcomes of heel-unloader vs conventional cast immobilisation. Methods: We retrospectively analyzed 101 calcaneal fractures treated with cast immobilization and partial weight-bearing or a heel-unloader with early full weight-bearing. Böhler angle (BA) loss, evaluating macroscopic fracture displacement and heel height, was the primary endpoint; secondary outcomes were pain, ankle/subtalar motion, complications, and radiologically subtalar degeneration. Equivalence in BA loss was tested by 2 one-sided tests (TOST). Results: Overall, 16.8% of the fractures were managed non-operatively and 83.2% operatively, with similar distributions between the groups ( Conclusion: Early full weight-bearing with a heel-unloader yields radiologically and clinically equivalent macroscopic results to traditional casting and is a safe alternative for early mobilization. Level of Evidence: Level III, retrospective comparative study.
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