The calcaneus, commonly known as the heel bone, is the large bone found at the back of the foot. It joins with the talus and cuboid bones to create the subtalar joint. A fracture is a medical condition in which a bone breaks, usually due to an injury or as a result of a particular medical issue. The different types of calcaneus fractures are determined by the extent of the damage and may include stable fractures, where the bone remains in place; displaced fractures, where the bone pieces shift out of alignment; open fractures, where the bone pierces the skin; closed fractures, where the bone breaks but does not break through the skin; and comminuted fractures, where the bone is broken into multiple pieces.
A fracture in the calcaneus bone typically happens due to a traumatic event, such as falling from a height, twisting the ankle, involvement in a car accident, sports injuries, or a sprained ankle.
A break in the calcaneus bone is seen as a severe injury and may lead to long-term issues if not properly treated. Patients often experience stiffness and discomfort in the affected joint, and there is a risk of developing arthritis as a result of the fracture.
The commonly seen signs and symptoms of calcaneal fractures are
- Pain in the heel
- Swelling in the heel
- Bruises in the heel
- Inability to walk or bear weight on the foot
The evaluation of a calcaneal fracture involves the use of imaging methods like X-ray and CT scan. The doctor decides on the best course of treatment based on the severity of the fracture.
Calcaneal fractures are managed according to the specific type of break and the degree of injury to the surrounding soft tissues.
Nonsurgical treatment
- Rest, ice, compression, and elevation (R.I.C.E.) – The most commonly used treatment option involves resting the injured foot, which can significantly aid in the healing of the fracture. Applying ice packs wrapped in a towel to the affected area helps reduce swelling and relieve pain. Using compression stockings or elastic bandages can also support the healing process and alleviate discomfort. Keeping the feet elevated above the level of the heart can further help in reducing swelling.
- Immobilization – Keeping the injured foot immobilized helps prevent the broken bone from shifting. It is recommended to use crutches while walking to avoid putting weight on the body until the injury has healed.
Surgical treatment
- Open reduction and internal fixation – This surgery involves putting the bone fragments back together with metal plates and screws to reposition them and set them to normal alignment.
- Percutaneous screw fixation – This is the best preferred treatment in cases where the bone pieces are large. The bone can either be pushed or pulled to set into place without making a large incision. Metal screws are then inserted and fixed through small incisions to hold the bone pieces together.
Rehabilitation
Irrespective of the treatment procedure, the patient is recommended to undergo physiotherapy and practice simple exercises regularly to help restore function. This would help the muscles to gain flexibility and after complete recovery, the patient can resume their daily living with normal activities.
