Fracture of the Heel Bone (Calcaneus)

Fractures of the calcaneus can be debilitating injuries. Usually these fractures occur when tremendous forces impact the foot and damage the heel. Examples are falls from heights or motor vehicle accidents. Imagine standing on an orange and seeing it widen and squash flat. This is essentially what happens to the calcaneus. 

The joint between the calcaneus and the talus is called the subtalar joint. This joint is responsible for the inward and outward movements of the foot, otherwise called inversion and eversion. When the calcaneus is fractured the movement of inversion and eversion is commonly decreased or lost completely. The upward and downward movement of the ankle (dorsiflexion and plantarflexion) is not usually affected by fractures of the calcaneus.

There are numerous problems associated with fractures of the calcaneus. One is the widening and deformity of the bone itself. Another is irregularity of the subtalar joint that leads to arthritis. Fractures to the calcaneus may also cause injuries to the heel cushion (the heel pad) and to the nerves and tendons surrounding the heel. 

The ideal goal of treatment is to restore the dimensions of the heel as accurately as possible. This is always difficult because of the multiple fragments of bone that are commonly present. It is almost like trying to piece together a jigsaw puzzle.

For the majority of patients, surgery is the correct form of treatment. The goal of surgery is to restore the correct size and structure of the heel. This is done by performing what is called an open reduction and internal fixation of the fracture. The open reduction and internal fixation procedure is performed through an incision on the outside of the heel. The bone is put together and held in place with a metal plate and multiple screws. This procedure decreases the likelihood of arthritis developing and maximizes the potential for inward and outward movement of the foot.

There are times, however, when the bone is so severely smashed and fractured that, in addition to the open reduction and internal fixation, the heel joint (the subtalar joint) needs to be fused. This is done to decrease the chances of developing painful arthritis. Although the inversion and eversion movement of the foot is lost after a subtalar fusion, there is a more rapid return to activities and functions after this type of surgery. 


The ideal time to perform surgery is when there is minimal swelling of the skin. The Doctor will often use a foot pump device applied to the foot for a few days to decrease the swelling. This allows him to perform the surgery as soon as possible.

Following surgery, no walking on the foot is permitted for approximately 3 months. A bandage is applied to the leg after surgery. After the stitches are removed, movement exercises and therapy are started to try to maximize the function of the foot. It typically takes approximately six months to recover from this type of injury.

Link: http://www.mdmercy.com/footandankle/conditions/trauma/fracture_heelbone.html

POSTED BY ATTORNEY RENE G. GARCIA:
- Some of our clients have suffered Calcaneus fractures due to a serious accident. The Garcia Law Firm, P.C. was able to successfully handle these types of cases. For a free consultation please call us at 1-866- SCAFFOLD or 212-725-1313.