Objectives: (i) To compare and correlate outcome in Sanders Type 2 Os Calcis fractures using two disease-specific scores (Kerr-Atkin score & American Orthopaedic Foot and Ankle society score) and a general quality of life score (short form 36 health status questionnaire). (ii) To compare results of operative with non operative treatment, in this group of patients.

Design: Retrospective study using a combination of case notes, plain x-rays and CT scan films review along with current clinical assessment.

Patients: 30 patients with 32 fractures of Os Calcis (Sanders type 2) were identified. These patients were treated during 1994–1997 with mean follow up of 40 months.

Intervention: 16 patients were treated by open reduction and internal fixation using a lateral approach. The remaining 14 patients were managed non operatively. Treatment modality was decided by consultant preference.

Outcome measurements: Kerr-Atkin score, AOFAS score, SF36.

Results: We found an extremely significant correlation (p,.001, Spearman) between the two disease specific scores. AOFAS score showed a stronger correlation with physical component summary score (PCS) of the SF36 than the Kerr-Atkin score.

The age of the patient had little impact on the Kerr-Atkins score but a large effect on PCS. Conversely the pre-op Bohlers angle, a measure of fracture severity, had a large effect on the Kerr-Atkins score but little impact on the PCS. The AOFAS was responsive to both these predictors: 41% of the variance in AOFAS score was explained by Bohlers angle and the age of the patient.

We did not find any significant difference in outcome between operative and non-operatively treated patients.

Conclusion: The AOFAS score was found superior in assessment of outcome for Sanders type 2 fractures, though the Kerr-Atkin score also performed well.

This study does not demonstrate any significant advantage of operative treatment in Sanders type 2 fractures of the Os Calcis.