Conservative approach benefits calcaneal fracture treatment

For the past several decades, treatment for calcaneal fractures has been extensively reported on. Some agreement can be reached concerning extra-articular calcaneal fractures. The treatment of intra-articular calcaneal fractures, however, remains a subject of much debate. The literature concerning this topic is replete with controversy. There is disagreement among authors concerning the treatment of these fractures on every level except one, which is the fact that the intra-articular calcaneal fracture is one of the most disabling injuries a patient can endure. In most cases, it leads to long-term disability and can be economically disastrous for the individual. In the last century many authors expressed discontent and frustration with treating calcaneal fractures, especially intra-articular fractures. Bankart in 1942 described them as "rotten."1 McLaughlin in 1959 described treating calcaneal fractures and likened it to "nailing a custard pie to a wall."2 Others have described them as "hopeless" and stated that "nothing should be done" concerning their treatment.3 This attitude started to change late in the century as advances in technology, imaging techniques, and our understanding of the biomechanics of these injuries were made.