Fractures of the Calcaneus

Heel Bone Fractures

Fractures of the calcaneus, or heel bone, can be severe, painful, and disabling. The calcaneus, along with the talus bone, comprise the subtalar joint, which is located below the ankle joint and is essential to inversion / eversion of the foot. It also forms a joint with the bone on the outside of the foot (cuboid).

The calcaneus is typically very hard to fracture. In most cases, heel bone fractures will occur as the result of high-energy impact, such as a fall or car accident. The heel can be crushed under the weight of the body and may widen, shorten, or become deformed. Following an injury, patients will commonly experience pain, swelling, bruising, deformity, and difficulty walking or putting weight on the heel.

Calcaneus fractures are relatively rare, but they can have severe and devastating consequences. Fractures can affect alignment of the heel bone and may also impact the subtalar joint, where it can damage articular cartilage and cause long-term complications such as arthritis, chronic pain, and reduced range of motion.

Nonsurgical Treatment

Treating a calcaneus fracture will focus on restoring the normal anatomy of the heel. In less severe fractures that are stable, nonsurgical treatment may be an option. Typically, this will involve the use of a cast, brace, or splint to protect and immobilize the ankle and foot while it heals. Patients may wear an immobilization device for 6 to 8 weeks, and should not bear weight on the affected foot until it is fully healed. Physical therapy during recovery can help improve mobility and strengthen supporting muscles.

Surgical Treatment

Because pieces of broken bone are often displaced by the force of an injury, calcaneus fractures often require surgery. Surgical treatment can also decrease risk of future complications, including loss of motion, foot impairment, and chronic arthritis. Surgery may also be required in cases of open fractures, where the fracture site is exposed or bone fragments stick out through the skin.

Surgical approaches will focus on restoring the normal shape of the heel bone and stabilizing the foot so it can heal in the correct position. Depending on the type of calcaneus fracture, the following procedures may be used:

  • Percutaneous screw fixation – When fractures involve large fragments of bone, these pieces can be manipulated into the correct position without the need for a large incision. Screws will then be used to hold the fracture together.
  • Open reduction and internal fixation – Displaced bones in the heel are repositioned into correct alignment through an open incision. They are then held in place using screws, metal places, or wires.

Recovery will vary from patient to patient, but may take weeks or up to three months before weight bearing can begin. Patients will work to improve motion, strength, and mobility through physical therapy and a gradual return to weight bearing and walking.

Torrance Memorial Physician Network

Our physicians at Torrance Memorial Physician Network offer comprehensive and personalized care to patients throughout the South Bay. If you have questions regarding calcaneus fracture treatment or surgery, call us to request an appointment with our foot and ankle specialist.