Patient-reported health-related quality of life after a displaced intra-articular calcaneal fracture: a systematic review

Abstract

BackgroundA displaced intra-articular calcaneal fracture (DIACF) is known for having a negative influence on the daily activities of patients. A health-related quality of life (HRQoL) outcome instrument is used to quantify the impact of DIACF. It seems that these studies used restrictive inclusion criteria and observe specific patient groups; consequently, an increased risk of bias that results in incorrect estimation of the impact. Therefore, we will systematically review the current literature.Materials and methodsA systematic search was performed in PubMed, Embase and Cochrane library. Inclusion criteria were studies reporting DIACF and HRQoL, measured with SF-36, SF-36v2, EQ-5D or EQ-6D. The identified articles were critically appraised for their relevance and validity. The overall risk of bias was determined. The studies with a low to medium risk of bias were used for data extraction.Results32 articles were available for the critical appraisal. 13 articles had a medium risk of bias. All studies reported the SF-36 and two studies also reported the EQ-5D.ConclusionsThis systematic review indicates that DIACF is a life-changing event for most patients. The HRQoL is substantially lower in comparison to the period before the trauma and to the general population, in particular the subdomains related to the physical domain are affected. In addition, this review reveals that the identified studies have a medium to high risk of bias. Consequently, it is challenging to make reliable and valid conclusions. Therefore, we provided recommendations to decrease the risk of bias in order to improve future research.

Association of pre-treatment radiographic characteristics of calcaneal fractures on patient-reported outcomes

“…Calcaneal fractures occur with a reported incidence that varies from 11.5 to 13.7 per 100,000 persons per year [1][2][3]. These fractures are known, among orthopaedic healthcare providers, to influence gait and functional outcome negatively [4,5]; moreover, these patients experience a lower quality of life than the general population [6][7][8].…”

A Trauma System wide Evaluation of the Demographic, Injury and Fracture Characteristics of Patients with Calcaneal Fractures: A Comparison of Trauma Level I and II Centers

“…Calcaneal fractures are a relatively uncommon injury that are known to influence the daily lives of patients negatively [1][2][3][4]. Most studies tend to focus on comparing treatments in patients with an intra-articular fracture including all different levels of trauma centers, mainly from trauma level I centers.…”

“…Most studies tend to focus on comparing treatments in patients with an intra-articular fracture including all different levels of trauma centers, mainly from trauma level I centers. The inclusion of patients from different trauma center levels might skew the outcome results [1]. To gain knowledge in the likely heterogeneity of demographic and injury characteristics in patients with calcaneal fractures, evaluation of patients in a large and consecutive cohort is needed.…”

Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity

“…Patients with significant nerve injuries are at an increased risk of functional deficits, socioeconomic debilitation, and narcotic abuse. 1 , 4 , 9 , 12 , 17 …”