Calcaneal Fractures

Calcaneal fractures, or fractures of the heel bone can be disabling, severe, and long-term injuries. 
The calcaneus is the most frequently fractured tarsal bone and account for 2% of all adult fractures. 60% of these fractures are calcaneus fractures. 
This injury typically occurs when a person has been in a motor vehicle accident or falls from a great height. In instances of car accidents, 10% of patients will also sustain another fracture- either in the spine, hip, or other foot. 
Injuries to this bone often damage the subtalar joint and cause the joint to become stiff, making it difficult to walk on uneven or slanted surfaces. 
There are several different types of calcaneal fractures, including:

• Stable fracture. This is a nondisplaced fracture. The broken ends of the bone meet correctly and are aligned, and therefore will stay in place to heal properly. 
• Displaced fracture. This type of fracture means that the parts of the bone do not meet up and therefore it will not heal properly on its own. Surgical intervention is often required to correct this fracture.
• Open fracture. This is a broken bone that comes through the skin, also known as a compound fracture. This is a complex injury because not only does it break the bone, it causes damage to the tissue, tendons, skin, and ligaments. Open fracture require a long time to heal.
• Closed fracture. With this injury, the broken bones do not pierce the skin, but still may damage soft tissues internally. 
• Comminuted fracture. This type of break is very unstable because the bone breaks into multiple pieces. 

Common symptoms include: pain, bruising, swelling, heel deformity, and inability to put weight on heel or walk. In some cases, you may be able to walk with a limp, therefore thinking the injury to be minor. You will experience pain in your heel and may think it to be unrelated to your injury.
When you talk with your podiatrist, it is important to tell them the exact details of your injury. How far did you fall? Your podiatrist will look for other injuries and areas where the skin is damaged or punctured. They may test other parts of your body, like your legs and spine to see if damage was done elsewhere. X-rays will be taken to determine what type of calcaneus fracture you have.
In determining your treatment, there are several things your podiatrist will consider:

• Cause of your injury
• Your overall health
• Severity of your injury
• Extent of soft tissue damage

Since most calcaneal fractures cause the bone to widen, the goal of treatment is to restore the normal anatomy of your heel. Nonsurgical treatment will include casting or another type of immobilization. You will not be able to put any weight on your foot until the bone is completely healed, which can take anywhere from six to eight weeks.
Surgical treatment is often required in more complicated cases. If the skin around the fracture has not been broken, your podiatrist will recommend waiting until the swelling has gone down, giving the skin that has been stretched time to heal. Waiting for surgery improves your overall chances for a better recovery from the surgery and reduces your risk of infection. Open fractures require immediate surgical attention, as an open wound invites infection and disease.
There are two different types of surgical procedures a podiatrist may do. An open reduction and internal fixation is used to reposition the bone fragments into their normal alignment. The fragments are held together with special screws or metal plates and screws. A percutaneous screw fixation moves the big bone pieces back into place by pushing or pulling on them without making a large incision.
Complications from a calcaneus fracture may include:

• Small areas of delayed wound healing
• Nerve irritation around the incision
• Tendon irritation caused by the screws
• Joint stiffness
• Chronic pain
• Blood clots
• Failure of the wounds to heal
• Infection
• Collapse of bone
• Arthritis

Seeking immediate attention after this injury is crucial in your recovery.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
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