In undisplaced, extra-articular calcaneal fractures is the use of a below knee POP associated with longer rehab period.

Report By: Dr Gabby May - Senior Clinical Fellow in Emergency Medicine
Institution: Manchester Royal Infirmary
Date Submitted: 2nd October 2006
Last Modified: 4th October 2006
Status: Blue (submitted but not checked)

Three Part Question

[In patients with undisplaced, extra-articular calcaneal fractures] is [the use of a below knee POP] detrimental [to speed of return to full weight bearing]?

Clinical Scenario

A 30 year old chap presents to the ED following a jump fom height, sustaining a right undisplaced extra-articular calcaneal fracture. He is not severely swollen, and you are happy to discharge him, with out-patient follow up. You wonder whether he should be placed in a below knee POP, or remain NWB without a POP, as then he will not lose movement at the ankle joint.

Search Strategy

MEDLINE OVID INTERFACE 1966-Sep 2006
exp Casts, surgical/ OR Immobilisation.mp. OR exp fracture fixation/ OR plaster.mp. OR POP.mp. OR plaster of paris.mp. AND calcaneal.mp. OR heel.mp. OR os calcis.mp. Limit to English and humans

Search Outcome

320 articles found, none relevant

Comment(s)

There have been no studies comparing outcome in those patients treated with and without POP. However, it would seem likely that if patients could be NWB but without POP they would not develop stiffness in the ankle and so possibly begin to wt bear earlier as pain settles. ?They would also theoretically have a lower risk of developing dvt.

Clinical Bottom Line

At present, local guidelines should be followed.