Calcaneus Fractures

Calcaneus Anatomy
The calcaneus is the heel bone. The Achilles' tendon attaches to the back of it. The plantar fascia attaches to the under surface of it. It is really exposed along its sides, posteriorly, medially and laterally with just an envelope of skin covering it.

The calcaneus forms an important joint with the talus above it. That joint is responsible for the actions of inversion and eversion of the hindfoot. That is called the subtalar joint. The calcaneus also forms a joint with the cuboid on the lateral side of the hindfoot.

How Calcaneus Fractures Occur
When you fall from a height and land on the heel the calcaneus will often be injured. Sometimes it will be bruised or have a contusion. If the fall has been high enough, and the surface you land on hard enough, the calcaneus bone may fracture. Some calcaneus fractures are simple, while others fragment the bone into multiple pieces.

Look here for a general discussion about Fractures.

Every fracture has a unique pattern. The plain x-rays often will describe the fracture pattern.

The calcaneus fractures are sometimes very complex, and we will often ask you to have a CAT scan done to evaluate the fracture more thoroughly.

Symptoms
Fracture pain is really not like any other type of pain. Most people have a very deep aching feeling that just does not let up. Most patients who have fractures are treated with a combination of narcotics and Tylenol for pain relief. Go here for a discussion of fracture pain.

With calcaneus fractures there is often a great deal of Swelling in the heel. Often there will be bruising, also. You will not be able to put weight on your heel.

Treatment of Calcaneus Fractures
The significant swelling that occurs with these fractures can influence the type and timing of treatment. In general, the two treatment options are to use a Cast and remain nonweightbearing, or have Surgery to try to put the pieces back together. It is generally not possible to do surgery when there has been a great deal of swelling. We will commonly wait for several weeks for the swelling to improve before performing surgery on calcaneus fractures.

The decision whether your fracture should be treated with casting, or you would be better with surgical treatment, is made based on the x-ray appearance, the examination of the foot, and a discussion with you about your activity level, age, and medical condition. The fracture will begin the Process of Healing from the instant it was broken.

If you have had a calcaneus fracture, it is very important to keep the foot elevated as high as possible, and as much as possible. This will help diminish the swelling. That will improve your discomfort, and if you have surgery will allow for better healing of the skin.