The effect of ongoing litigation on outcome scores following open reduction and internal fixation of the calcaneum.

All sixteen patients who had undergone open reduction and internal fixation (ORIF) of the calcaneum by the senior author between April 1993 and August 1996 were included in the study. Two had died from unrelated illnesses and one had failed to attend any follow-up following discharge. The remaining 13 were reviewed by the main author. As part of a complete clinical, radiological and functional assessment, Buckley and Meek (B&M) and Kerr and Atkins (K&A) outcome scores were calculated as well as a satisfaction score obtained by a visual analogue scale (VAS). Statistical analysis of the results using Wilcoxen's paired and unpaired ranking scores showed that the initial grade of the fracture, degree of operative reduction, correction of width of the heel and post-operative ranges of motion had no significant correlation to either B&M or K&A outcome scores or to the VAS score. However, the presence of ongoing litigation was significantly correlated to the scores (VAS < 0.01, B&M < 0.05, K&A < 0.05). These findings cast doubt on the validity of post operative scoring for fracture of the calcaneum in the presence of ongoing litigation.