Introduction: The aim of our study was to assess any difference in outcome between non-surgical and surgical treatment of displaced calcaneal fractures.

Materials and Methods: We studied 40 patients between 2000 to 2005 with displaced calcaneal fractures. Patients with significant co-morbidities were excluded. Two groups of 14 patients, surgery vs. no surgery were compared for age, sex, length of follow-up, fracture type by Essex-Lopresti classification and SF-36 outcome score. The non-surgical group underwent treatment with rest, ice, compression, elevation and the surgical group underwent fixation with an AO calcaneal plate through an extended lateral approach.

Results: There was no statistically significant difference between the surgical and conservatively treated groups for age, sex, time since injury and fracture type according to Essex-Lopresti but a highly statistically significant difference in SF-36 outcomes between the two groups favouring surgically treated calcaneal fractures.

Summary: Displaced fractures of the calcaneum are a significant injury affecting patients general health. In the literature controversy exists as to whether operative or non-operative treatment is better for this type of fracture.

Conclusion: Although the numbers are small, our study favours operative intervention, if possible, for this controversial fracture.