{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:36:09Z","timestamp":1777613769706,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Orthoteam"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Standard treatment of calcaneal fractures involves prolonged immobilization with partial weight-bearing, risking ankle stiffness and lower-leg deconditioning. The heel-unloader enables early full weight-bearing by redirecting axial load from the hindfoot to the midfoot, forefoot, and lower leg. This study compares radiologic and clinical outcomes of heel-unloader vs conventional cast immobilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed 101 calcaneal fractures treated with cast immobilization and partial weight-bearing or a heel-unloader with early full weight-bearing. B\u00f6hler angle (BA) loss, evaluating macroscopic fracture displacement and heel height, was the primary endpoint; secondary outcomes were pain, ankle\/subtalar motion, complications, and radiologically subtalar degeneration. Equivalence in BA loss was tested by 2 one-sided tests (TOST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 16.8% of the fractures were managed non-operatively and 83.2% operatively, with similar distributions between the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.397). After 4\u2009weeks of non-weight-bearing, 59 (58.4%) fractures continued in a heel-unloader and 42 (41.6%) with a cast. Baseline and fracture characteristics were comparable. Mean BA loss at 12\u2009weeks was \u22124.7\u00b0\u2009\u00b1\u20095.3\u00b0 (heel-unloader group) vs \u22123.8\u00b0\u2009\u00b1\u20095.5\u00b0 (cast group) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.44), confirming equivalence (TOST\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Other outcomes showed no significant differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Early full weight-bearing with a heel-unloader yields radiologically and clinically equivalent macroscopic results to traditional casting and is a safe alternative for early mobilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114261434237","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:46:10Z","timestamp":1776692770000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Full Weight-Bearing After Calcaneal Fracture Using a Heel-Unloader Orthosis: Equivalent Radiographic Outcomes Compared to Traditional Cast Treatment"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0818-3863","authenticated-orcid":false,"given":"Verena","family":"Hecht","sequence":"first","affiliation":[{"name":"Inselspital Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5668-0733","authenticated-orcid":false,"given":"Fabian","family":"Krause","sequence":"additional","affiliation":[{"name":"Inselspital Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Anwander","sequence":"additional","affiliation":[{"name":"Inselspital Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2012.01.007"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/b-006-149767"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-025-00863-w"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/63.10.1076"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200210000-00001"},{"key":"e_1_3_2_7_2","article-title":"Proof of functionality of the heel relief orthosis according to Dr. Settner\/M\u00fcnch","volume":"2","author":"M\u00fcnch T","year":"2002","unstructured":"M\u00fcnch T. 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