Calcaneal Fracture Information:
Fractures of the calcaneus (heel bone) or talus (ankle bone) typically occur after a high velocity injury such as a fall from a height or as a result of a motor vehicle accident. Due to the force of the injury, the damage is often extensive and often requires surgery. These injuries can lead to arthritis of the ankle and subtalar joint.
The goal of surgery is to realign the bone and also decrease the chance of avascular necrosis or loss of blood supply to the bone. Correct alignment is essential to prevent arthritis and the use of screws and a possible plate allows for rigid fixation to prevent or decrease the chance of future problems.
Conservative Care of Calcaneal Fractures
In cases of simple fracture, use of a cast and crutches with a possible electrical bone stimulator to allow for rapid healing may be used. It often will take about 6-8 weeks of no weight on the foot to allow the fracture to heal and then another 6-8 weeks of physical therapy is necessary to get the patient back to normal walking.
Surgical Treatment of Calcaneal Fractures
In most cases of a calcaneal fracture, it is necessary to perform surgery to realign the heel bone and especially to get the cartilage surface that articulates with the talus in good position. In general, if the cartilage is off by more than 2 millimeters, there is a good change of arthritis developing. Part of the problem with a calcaneal fracture is that the heel bone is like an egg with very thin walls. With trauma, the walls crack into multiple pieces and shift around causing cartilage damage.
The goal of surgery is to realign the heel under the leg, decrease the width of the heel and also to realign the cartilage surface as close to normal levels and possible. Fixation is achieved with a large plate and multiple screws which allows better positioning of the small pieces of broken bone.
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