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