Calcaneal Fracture

WHAT YOU SHOULD KNOW:

• A calcaneal (kal-KA-ne-al) fracture (FRAK-chur) is a break, crack, or damage in the calcaneus or heel bone. The calcaneus is the largest and most common injured bone of the foot. The heel and talus bones are connected with strong tissues that attach them together. It supports the weight of the body while walking or doing activities. Heel bone fractures may happen because of a fall, car accident, or while playing sports. You may also break your heel bone from a direct blow or by badly turning your ankle the wrong way. You may have pain, swelling, bruising, or trouble moving your ankle and foot. The foot of the injured heel may feel weak, numb, or tingly.
  
  
• The broken heel bone may also cut or tear the ligaments (tissues that connect bones) causing more problems. A bone scan, x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), and fluoroscopy may be used for diagnosis. Medicines to control pain and prevent infection from germs and tetanus may be given. A walking cast or a splint may be used to treat a mild heel fracture. Very severe (bad) fractures may need surgery to put the bones and ligaments back together. Special screws, plates, pins, and wires may be used in surgery. With treatment and care, your calcaneal fracture may heal completely and you may be able to resume your usual activities.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Treatment of a calcaneal fracture may have risks. Having a cast for a period of time may cause discomfort and problems walking. You could get an infection or bleed too much with surgery. Sometimes, even after surgery, the heel may not go back to the way it was before, or symptoms may not go away. If left untreated, a calcaneal fracture may cause problems with walking and activities, including sports. You may get an infection if the fracture has an open wound. You may also have decreased blood supply to the injured area. This may cause necrosis (death) of the foot that may lead to an amputation (cutting-off). Call or ask your caregiver for more information about your condition, medicine or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Medicines:

• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Tetanus shot: This is medicine to keep you from getting tetanus. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

Tests:

• Bone scan: This is a test to look at your bones. You are given a small, safe amount of radioactive dye in an IV. Pictures are then taken of your bones. Caregivers can look at the pictures for broken bones, infections, or cancer in the bones.
  
  
• Computed tomography (CT) scan: A special x-ray machine uses a computer to take pictures of your ankle and foot. It may be used to look at bones, muscles, and blood vessels. You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
• Fluoroscopy: This procedure uses an x-ray that shows movement of the bone or joint as a shot of anesthesia is given. Anesthesia is numbing medicine to decrease pain so your caregiver may know where exactly the broken bones are.
  
  
• Magnetic resonance imaging (MRI): During the MRI, pictures are taken of your ankle and foot. An MRI may be used to look at the muscles, joints, bones, or blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  
  
• X-ray: You may need ankle and foot x-rays to check for broken bones and other problems in your heel. Several pictures may be taken of the bones in your ankle and foot.

Treatment options:

• Immobilization: This method is used in mild calcaneal fractures to protect your heel from further injury. It provides support to the foot and prevents movement to help bones heal. It may include a walking cast, compression dressings, traction, splint, or a cast boot.
  
  
• Surgery: This is done for very bad broken heel bones or if the ligaments are also damaged. Ligaments are strong tissues that connect one bone to another. Surgery helps put the bones and ligaments back in their proper position. This may include the use of special wires, pins, plates or screws. Ask your caregiver for more information about an internal or external fixation for a calcaneal fracture.
  
  
• Others: Your caregiver may do a closed reduction. This is for a broken bone that has no open wound and does not need screws, plates, pins, or wires to put them in place. Ask your caregiver for more information about closed reduction.

Overhead trapeze: This is a metal triangle-shaped grab bar that is hung on the frame of your hospital bed. Caregivers will teach you how to safely use the trapeze to move and change positions while in bed.

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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