.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
Displaced intra-articular calcaneal fractures remain a difficult treatment problem because surgery can restore anatomy but may also create wound and soft-tissue complications. Long-term follow-up from the UK Heel Fracture Trial provides an important counterbalance to procedure-driven thinking. At five years, patients randomised to open reduction and internal fixation did not have better functional scores than those treated nonoperatively. Walking difficulty and shoe-wear outcomes were also similar. Importantly, the operative group underwent more additional surgical procedures. These results apply to selected closed, displaced intra-articular fractures without severe deformity causing fibular impingement or other major indications for surgery. The clinical implication is that anatomical restoration by ORIF does not automatically produce superior long-term function. For HCPs, treatment should therefore consider soft-tissue status, fracture morphology, patient expectations and the potential morbidity of surgery. ORIF can still be appropriate in selected cases where deformity threatens function or causes mechanical impingement, but the trial argues against routine fixation as a default strategy. Shared decision-making should include the possibility that conservative management may provide comparable long-term function with fewer operations.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
Displaced intra-articular calcaneal fractures remain a difficult treatment problem because surgery can restore anatomy but may also create wound and soft-tissue complications. Long-term follow-up from the UK Heel Fracture Trial provides an important counterbalance to procedure-driven thinking. At five years, patients randomised to open reduction and internal fixation did not have better functional scores than those treated nonoperatively. Walking difficulty and shoe-wear outcomes were also similar. Importantly, the operative group underwent more additional surgical procedures. These results apply to selected closed, displaced intra-articular fractures without severe deformity causing fibular impingement or other major indications for surgery. The clinical implication is that anatomical restoration by ORIF does not automatically produce superior long-term function. For HCPs, treatment should therefore consider soft-tissue status, fracture morphology, patient expectations and the potential morbidity of surgery. ORIF can still be appropriate in selected cases where deformity threatens function or causes mechanical impingement, but the trial argues against routine fixation as a default strategy. Shared decision-making should include the possibility that conservative management may provide comparable long-term function with fewer operations.
4 weeks back
A bioengineered oral nanozyme microsupplement converts pathological ROS into a protective polydopamine hydrogel shield. By curbing neutrophil extracellular traps and balancing T cells, this platform outperforms standard 5-ASA in preclinical colitis models, opening new paths for sustained remission.
4 days back
Recent research reveals that downregulating YAP1/TAZ-TEAD via Hippo signaling triggers spontaneous human trophoblast syncytialization in 3D cultures, illuminating placental biology and preeclampsia.
4 weeks back
Abdominal aortic aneurysm rupture remains a catastrophic vascular emergency. Groundbreaking research reveals that USP53 accelerates aneurysm progression by reprogramming smooth muscle cell metabolism toward aerobic glycolysis, highlighting a promising target beyond conventional diameter-based surveillance.
5 days back
A breakthrough study leverages natural language processing to accurately identify incident medication-related osteonecrosis of the jaw and track antiresorptive drug holidays from clinical narratives in electronic health records, advancing osteoporosis pharmacovigilance and dental safety.
4 days back
Recent research defines ferro-aging as a conserved iron-lipid axis driving organ decline across primates. Age-related iron dyshomeostasis stimulates ACSL4-mediated lipid peroxidation, promoting cellular senescence. Notably, vitamin C directly inhibits ACSL4, suppressing phospholipid oxidation and multi-organ decay.
5 days back
