Heel Fractures

The calcaneus or heel bone is a large bone found at the rear end of the foot. The calcaneus connects with the talus and cuboid bones to form the subtalar joint of the foot. A fracture is a break in a bone following trauma or due to various conditions. A calcaneus fracture can be categorized as a stable fracture, displaced fracture, open fracture, closed fracture or comminuted fracture, depending on its severity.

A fracture of the calcaneus occurs most commonly due to a traumatic event such as falling from a height, twisting injury, motor accident, sports injury or ankle sprain.

A fracture of the calcaneus is considered serious and can cause longstanding problems if not treated effectively. Stiffness and pain in the joint, and arthritis are common risks following a calcaneal fracture.

The common signs and symptoms of calcaneal fractures are

• Pain 
• Swelling 
• Bruising
• Inability to walk or bear weight on the injured foot

Calcaneus fractures are diagnosed with an X-ray or CT scan. 

Calcaneal fractures are treated based on the type of fracture and extent of soft tissue damage. Treatment options may include:

• Nonsurgical treatment
  • Rest, ice, compression and elevation (R.I.C.E.) is the most commonly used treatment option. Staying off (resting) the injured foot can alleviate the symptoms to a great extent. Covering the affected area with ice packs over a towel reduces swelling and pain. Compression stockings and elastic bandages can also aid in alleviating pain. Positioning the foot above the level of your heart helps reduce swelling.
  • Immobilization – Casting the injured foot prevents the fractured bone from moving. Walking with the help of crutches is advised to avoid bearing your body weight until healing has occurred.
• Surgical treatment
  • Open reduction and internal fixation – This surgery involves putting the bone fragments back together with metal plates and screws to reposition them and set them to normal alignment.
  • Percutaneous screw fixation – This is the best preferred treatment when the broken bone pieces are large. The bone can either be pushed or pulled to set into place without making a large incision. Metal screws are then inserted and fixed through small incisions to hold the bone pieces together.

Rehabilitation

Following treatment, the patient is recommended to perform simple exercises and undergo physical therapy to help restore flexibility and function. After complete recovery, the patient can resume their daily living with normal activities.