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  • Fractures of the Calcaneus (Heel Bone Fractures)

What is the Calcaneus? 
The calcaneus, also called the 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.

 

Calcaneal1

The calcaneus is often compared to a hard boiled egg, because it has a thin, hard shell on the outside and softer, spongy bone on the inside. When the outer shell 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.

How do Calcaneal Fractures Occur?
Most calcaneal fractures are the result of a traumatic event—most commonly, falling from a height, such as a ladder, or being in an automobile accident where the heel is crushed against the floorboard. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. A smaller number of calcaneal fractures are stress fractures, caused by overuse or repetitive stress on the heel bone.

Types of Calcaneal Fractures 
Fractures of the calcaneus 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 connective tissue between two bones). The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.

Calcan Fractures 1

Fractures that don’t involve the joint (extra-articular fractures) include:

  • Those caused by trauma, such as avulsion fractures (in which a piece of bone is pulled off of the calcaneus by the Achilles tendon or a ligament) or crush injuries resulting in multiple fracture fragments
  • Stress fractures, caused by overuse or mild injury.

The severity and treatment of extra-articular fractures depend on their location and size.

   Calcan Fractures 2

Signs and Symptoms 
Calcaneal fractures produce different signs and symptoms, depending on whether they are traumatic or stress fractures.

The signs and symptoms of traumatic fractures may include:

  • Sudden pain in the heel and inability to bear weight on that foot
  • Swelling in the heel area
  • Bruising of the heel and ankle

The signs and symptoms of stress fractures may include:

  • Generalized pain in the heel area that usually develops slowly (over several days to weeks)
  • Swelling in the heel area

Diagnosis 
To diagnose and evaluate a calcaneal fracture, the foot and ankle surgeon will ask questions about how the injury occurred, examine the affected foot and ankle, and order x-rays. In addition, advanced imaging tests are commonly required.

Treatment 
Treatment of calcaneal fractures is dictated by the type of fracture and extent of the injury. The foot and ankle surgeon will discuss with the patient the best treatment—whether surgical or non-surgical—for the fracture.

For some fractures, non-surgical treatments may be used. These include:

  • Rest, ice, compression, and elevation (R.I.C.E.) Rest (staying off the injured foot) is needed to allow the fracture to heal. Ice reduces swelling and pain; apply a bag of ice covered with a thin towel to the affected area. Compression (wrapping the foot in an elastic bandage or wearing a compression stocking) and elevation (keeping the foot even with or slightly above the heart level) also reduce the swelling.
  • Immobilization. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Crutches may be needed to avoid weightbearing.

For traumatic fractures, treatment often involves surgery to reconstruct the joint, or in severe cases, to fuse the joint. The surgeon will choose the best surgical approach for the patient.

Rehabilitation 
Whether the treatment for a calcaneal fracture has been surgical or non-surgical, physical therapy often plays a key role in regaining strength and restoring function.

Complications of Calcaneal Fractures 
Calcaneal fractures can be serious injuries that may produce lifelong problems. Arthritis, stiffness, and pain in the joint frequently develop. Sometimes the fractured bone fails to heal in the proper position. Other possible long-term consequences ofcalcaneal fractures are decreased ankle motion and walking with alimp due to collapse of the heel bone and loss of length in the leg. Patients often require additional surgery and/or long term or permanent use of a brace or an orthotic device (arch support) to help manage these complications.

  • Bone/Joint/Tendon
    • Accessory Navicular Syndrome
    • Achilles Tendon Rupture
    • Ankle
      • Ankle Arthritis
      • Ankle Fractures
      • Ankle Pain
      • Ankle Sprain
      • Swollen Ankles
      • Tarsal Coalition
      • Tarsal Tunnel Syndrome
      • Weak Ankles
    • Arch Pain
    • Arch Supports
    • Bone Healing
    • Bone Infection
    • Bone Tumors in the Foot
    • Brachymetatarsia
    • Bunions (Hallux Abducto Valgus)
    • Bursitis
    • Calcaneal Apophysitis (Sever's Disease)
    • Calf Pain
    • Capsulitis of the Second Toe
    • Cavus Foot (High-Arched Foot)
    • Charcot Foot
    • Chronic Ankle Instability
    • Clubfoot
    • Cold Feet
    • Common Disorders of the Achilles Tendon
    • Drop Foot
    • DVT (Deep Vein Thrombosis)
    • Extra Bones
    • Fallen Arches
    • Fifth Metatarsal Fracture
    • Flatfoot
      • Flatfoot-Adult Acquired
      • Flatfoot-Flexible
      • Flatfoot-Pediatric
    • Foot Arthritis
    • Foot Drop
    • Fracture
      • Foot Fracture
      • Fracture-Ankle
      • Fracture-Foot
      • Fractures of the Calcaneus (Heel Bone Fractures)
      • Fractures of the Fifth Metatarsal
      • Fracture-Toe
      • Jones Fracture
      • Stress Fracture in the Foot
      • Toe and Metatarsal Fractures (Broken Toes)
    • Gangrene
    • Gout
    • Haglund's Deformity
    • Hallux Rigidus
    • Hammertoes
    • Heel Pain (Plantar Fasciitis)
    • High-Arched Foot
    • Intermetatarsal Neuroma
    • Intoeing
    • Joint Pain in the Foot
    • Joint Swelling in the Foot
    • Lisfranc Injuries
    • Os Trigonum Syndrome
    • Osteoarthritis of the Foot and Ankle
    • Osteomyelitis (Bone Infection)
    • Osteopenia
    • Osteoporosis
    • Peroneal Tendon Injuries
    • Pigeon-toes
    • Posterior Tibial Tendon Dysfunction (PTTD)
    • R.I.C.E Protocol
    • Restless Legs
    • Rheumatoid Arthritis in the Foot and Ankle
    • Sesamoid Injuries in the Foot
    • Shin Splints
    • Swollen Feet
    • Synovitis
    • Tailor's Bunion
    • Talar Dome Lesion
    • Tingly Feet
    • Tired Feet
    • Toe Walking
    • Turf Toe
    • Varicose Veins
    • Webbed Toes
  • Nails and Skin
    • Athlete's Foot
    • Black Toenails
    • Callus
    • Contact Dermatitis
    • Corns
    • Cracked Heels
    • Dermatitis
    • Dry Heels
    • Eczema of the Foot
    • Foot Bumps
    • Foot Lumps
    • Foot Odor
    • Foot Rash
    • Frostbite
    • Fungal Nails
    • Ganglion Cyst
    • Heel Fissures
    • Inflammation: Acute
    • Ingrown Toenails
    • Malignant Melanoma of the Foot
    • Plantar Fibroma
    • Plantar Wart (Verruca Plantaris)
    • Pump Bump (Hallux Rigidus)
    • Puncture Wounds
    • Rash
    • Raynauds Phenomenon
    • Skin Cancer of the Foot and Ankle
    • Smelly Feet
    • Sweaty Feet
    • Thick Toenails
    • Warts
    • White Toenails
    • Wounds/Ulcers
    • Wounds-Puncture
    • Yellow Toenails
  • Diabetic Health
    • Diabetic Complications and Amputation Prevention
    • Diabetic Foot Care Guidelines
    • Diabetic Peripheral Neuropathy
    • Diabetic Shoes
    • MRSA Infection of the Foot
    • Peripheral Arterial Disease (P.A.D.)
    • Soft Tissue Biopsy
  • Fitness and Your Feet
    • Baseball Injuries to the Foot and Ankle
    • Basketball Injuries to the Foot and Ankle
    • Field Hockey Injuries to the Foot and Ankle
    • Football Injuries to the Foot and Ankle
    • Golf Injuries to the Foot and Ankle
    • Lacrosse Injuries to the Foot and Ankle
    • Rugby Injuries to the Foot and Ankle
    • Running and Track Injuries to the Foot and Ankle
    • Soccer Injuries to the Foot and Ankle
    • Softball Injuries to the Foot and Ankle
    • Tennis Injuries to the Foot and Ankle
    • Volleyball Injuries to the Foot and Ankle
  • Orthotics and Footwear
    • Custom Orthotic Devices
    • Orthotics
    • Shoe Inserts
  • Compartment Syndrome
  • Deep Vein Thrombosis (DVT)
  • Equinus
  • Instructions for Using Crutches
  • Staph Infections of the Foot

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Ashburn: 20905 Professional Plaza, Suite 310 Ashburn, VA 20147 Tel:(703) 723-9267
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