Calcaneal Fracture

WHAT YOU SHOULD KNOW:

• A calcaneal (kal-KA-ne-al) fracture 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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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, your heel may not go back to the way it was before, or your symptoms may not go away. You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• If left untreated, a calcaneal fracture may cause problems with walking and activities, including sports. You may get an infection if you have an open wound. You may also have decreased blood supply to the injured area. This may cause necrosis (tissue death), and you may need amputation (removal of the foot). Call or ask your caregiver for more information about your condition, medicine or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

Tests:

• Bone scan: This is a test to look at your bones. You are given a small amount of dye through an IV, and pictures of your bones are taken. Caregivers can look at the pictures for broken bones, infections, and other problems.
  
  
• 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:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

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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.

Learn more about Calcaneal Fracture (Inpatient Care)