Our study investigated a consecutive series of 53 cal-caneal fractures treated at Southend General Hospital during a 4 year period. In total 75% were intrarticular and 25% extrarticular. Overall 51.92% of patients underwent operative intervention 66.67% of these being intrarticular. All patients underwent AOFAS scoring. The minimum followup period was 6 months and the average was 18 months.

In the non-operative group (Undisplaced intra/extrarticular with Bohler’s angle 20–40 degrees) the < 50 year old group had an average AOFAS score of 86.3 versus 63.64 in the > 50 year old group.

In the operative group the AOFAS score was heavily dependent upon restoration of Bohler’s angle. This study shows that if Bohler’s angle is < 20 degrees the average AOFAS score after followup was 51.00 but if the angle has been restored to > 20 degrees the average score is 69.53. This result is reinforced by the fact that 75% of patients returned to work in the > 20 degree Bohler’s angle group wheras only 33.34% returned to work in the < 20 degree group.

This study shows that surgical restoration of Bohler’s angle to > 20 degrees gives a better outcome than for conservative treatment.