New UK trial to test effectiveness of surgery on serious heel fractures
The effectiveness of routine surgery to treat severe heel fractures compared to non-surgical treatment is to be tested by a major new clinical trial involving 150 patients in 18 hospitals around the UK.
The half a million pound trial will be co-ordinated by surgeons and academics at the University of Warwick in Coventry and funded by the Arthritis Research Campaign (arc).
Severe heel injuries are suffered by about 2,000 people in the UK every year due to crushing and fracturing usually as a result of road accidents or falling off ladders. In the worst cases the injury leads to arthritis and a painful, deformed foot, and many people affected never work again.
Now a team at the Warwick Medical School Department of Trauma and Orthopaedic Surgery based at University Hospital Coventry and Warwickshire, led by Professor Damian Griffin, aims to find whether an operation to repair the heel bone and joint is better than non-surgical treatment. Centres in Middlesbrough, Sheffield, London, Liverpool, Leeds, Cambridge, Norfolk, Birmingham, Wirral, Cardiff and Wrexham are also recruiting.
“Current opinion is divided as to the best method of treating these fractures, and there is a need for high quality research to investigate whether the possible advantages of surgery outweigh the risks,” explained Professor Griffin, Professor of Trauma and Orthopaedic Surgery.
“Surgery might prevent arthritis, and hence pain and loss of movement. But there are risks, particularly of infection deep in the heel bone, and we don’t really know if the operation is better than non-surgical treatment. The results of this trial will help us answer that question.”
Both the surgical group and non-surgical group will spend 12 weeks on crutches and undergo physiotherapy. For six weeks they will put no weight on their foot, then gradually put more weight on it for a further six week period as they get better.
Both groups will be assessed after six months, 12, and 18 months, and finally at two years. “If surgery is shown to be more effective than non-operative treatment, this will better inform our management of this important group of patients,” added Professor Griffin.
For more information about taking part in the trial contact co-ordinator Dr Rose Jarvis at Warwick Medical School at Clinical Sciences Research Centre in Coventry on 02476 968625 or r.m.jarvis@warwick.ac.uk
