Experience in the treatment of comminuted fractures of the os calcis in the decade prior to 1930 was most unsatisfactory. Many industrial insurance companies were accustomed to put aside a rather large reserve in the case of such fractures. Their experience with all forms of treatment was so unfortunate that in the state of California they were refusing to allow the surgeons to do other than manipulate and apply a plaster boot. Their experience with subastragaloid arthodesis was such that few companies could be persuaded even in cases of the most serious disability to allow the procedure. In general, the attitude was that such a fracture was unfortunate, that long-continued disability would follow and that there would of course be a high degree of permanent disability.
Experience in private cases was not quite so unfavorable but in the main was unhappy. It was noted that, in the average case of
SPIERS HW. COMMINUTED FRACTURES OF THE OS CALCIS. JAMA. 1938;110(1):28-31. doi:10.1001/jama.1938.02790010030006