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Calcaneus (Heel Bone)Fractures
Lead Expertise in Bone Surgery and Joint Replacement
Calcaneal Fractures /heel bone, is a large bone that forms the foundation of the rear part of the foot. The calcaneus connects with the talus and cuboid bones. The connection between the talus and calcaneus forms the subtalar joint. This joint is important for normal foot function.
When the outer shell of the bone is broken, the bone tends to collapse and become fragmented. For this reason, Calcaneal Fractures are severe injuries.
Furthermore, if the fracture involves the joints, there is the potential for long-term consequences, such as arthritis and chronic pain.
Types of Calcaneal Fractures (Heel bone) Fractures
Calcaneal Fractures may or may not involve the subtalar and surrounding joints.
Fractures involving the joints (intra-articular fractures) are the most severe calcaneal fractures and include damage to the cartilage. The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.
Fractures that do not involve the joint (extra-articular fractures) include: Those caused by trauma, such as avulsion fractures or crush injuries resulting in multiple fracture fragments and Stress fractures caused by overuse or mild injury
The severity and treatment of extra-articular fractures depend on their location and size.
Causes of Calcaneal Fractures (Heel Bone) Fractures
Calcaneal Fractures occur mostly during :
Fall from a height , Twisting injury to the ankle, Motor vehicle collision
The severity of a fracture can vary. For example, a simple twist of the ankle may result in a single crack in the bone. The force of a head-on car collision, however, may result in the bone being shattered.
Similar fractures can result from different mechanisms. For example, if you land on your feet from a fall, your body’s weight is directed downward. This drives the talus bone directly into the calcaneus.
In a motor vehicle crash, the calcaneus is driven up against the talus if the heel is crushed against the floorboard. In both cases, the fracture patterns are similar. As a rule, the greater the impact, the more the calcaneus is damaged.
In a high-energy fracture, other injuries, such as fractures of the spine, hip, or other heel, can occur.
Symptoms of Calcaneal Fractures (Heel Bone) Fractures
Patients with Calcaneal Fractures usually experience:
- Heel deformity
- Inability to put weight on the heel or walk
- Sudden pain in the heel and inability to bear weight on that foot
- Swelling and bruising in the heel area
With some minor Calcaneal Fractures, the pain may not be enough to prevent you from walking — but you may limp.
If, however, your calcaneus is deformed by the injury, your muscle and tendon cannot generate enough power to support your weight. Your foot and ankle will feel unstable, and you will walk differently.
Treatment of Calcaneal Fractures (Heel Bone) Fractures
Your doctor will consider several factors in planning your treatment, including:
- The cause of your injury
- Your overall health
- The severity of your injury
- The extent of soft tissue damage
Because most Calcaneal Fractures cause the bone to widen and shorten, the goal of treatment is to restore the normal anatomy of the heel. In general, patients whose normal heel anatomy is restored have better outcomes. In most cases, recreating the normal heel anatomy involves surgery. Your doctor will discuss the different treatment options with you.
Nonsurgical treatment of Calcaneal Fractures may be recommended if the pieces of broken bone have not been displaced by the force of the injury
Immobilization. A cast, splint, or brace will hold the bones in your foot in proper position while they heal. You may have to wear a cast for 6 to 8 weeks — or possibly longer. During this time, you will not be able to put any weight on your foot until the bone is completely healed.
Nonsurgical treatment of some fractures, however, can also lead to long-term complications, such as pain, arthritis, and a limp.
Your doctor will review the details of your injury and talk with you about the risks and benefits of surgical versus nonsurgical treatment.
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Surgical complications
Surgical Treatment
Surgery to repair a calcaneus fracture can restore the normal shape of the bone but is sometimes associated with complications, such as wound healing problems, infection, and nerve damage.
Surgical procedure. The following procedures are used for various types of calcaneus fractures:
- Percutaneous screw fixation. If the bone pieces are large, they can sometimes be moved back into place without making a large incision. Special screws are then inserted through small incisions to hold the fracture together.
- Open reduction and internal fixation. During this operation, an open incision is made to reposition (reduce) the bones into their normal alignment. They are held together with wires or metal plates and screws.
Major complications include:
- Failure of the wound to heal
- Infection
- Posttraumatic arthritis (with or without surgery)
- Complications often occur with calcaneus fractures. Minor complications include:
- Small or temporary areas of delayed wound healing
- Nerve irritation around the incision
- Tendon irritation
- Joint stiffness
- Chronic pain
- Chronic swelling