The impact of postoperative calcaneocuboid joint articular surface gap and step on long-term outcomes in surgically treated calcaneal fractures: a brief report

Background Calcaneal fractures, the most common tarsal fractures, often result in significant long-term disability and impose substantial healthcare burdens. Surgical intervention aims to restore hindfoot anatomy, but the role of calcaneocuboid joint reduction quality in determining long-term outcomes remains unclear. This study evaluated the impact of calcaneocuboid joint reduction quality on functional outcomes and the need for reoperation in surgically treated patients with calcaneal fractures. Methods This retrospective cohort study included 42 adult patients who underwent surgical treatment for calcaneal fractures. Postoperative computed tomography (CT) scans were analyzed to assess calcaneocuboid joint parameters, specifically gap and step. Functional outcomes were measured using the Manchester Oxford Foot Questionnaire (MOXFQ), and patient interviews were conducted to document the need for reoperations during the follow-up period. Results The median follow-up duration was 6.5 years. Neither the postoperative gap nor step of the calcaneocuboid joint significantly correlated with MOXFQ total scores (gap: Spearman’s r = 0.15, P = 0.336; step: Spearman’s r = 0.19, P = 0.239). Additionally, no significant differences in MOXFQ scores were observed between patients with anatomic and non-anatomic reductions ( P = 0.548). However, non-anatomic calcaneocuboid joint reduction was significantly associated with a 4.44-fold increased hazard of reoperation in this cohort (hazard ratio: 4.44, 95% CI: 1.48 to 13.31, P = 0.008). Conclusion While calcaneocuboid joint reduction quality did not significantly affect functional outcomes, the observed association with an increased hazard of reoperation highlights the need for further research to validate these findings and explore potential clinical implications.