Calcaneal Fracture

GENERAL INFORMATION:

What is a calcaneal fracture? A calcaneal (kal-KA-ne-al) fracture (FRAK-chur) is a condition where the calcaneus bone, also called the heel bone, is damaged or broken. The heel bone is the largest and most frequently broken bone of the foot. It supports the weight of the body during walking. Athletes, soldiers, and obese (very overweight) persons may have a higher risk for a calcaneal fracture.

What causes a calcaneal fracture? A calcaneal fracture may be caused by any of the following:

• Accidents with a motor vehicle.
  
  
• Chronic (long term) bone diseases such as osteogenesis imperfecta (bone development failure) and rheumatoid arthritis (swelling of the joints).
  
  
• Direct blow to the heel, or landing badly on your ankle or foot.
  
  
• Injuries from sports, such as basketball, soccer, football, ballet and ice-skating.

What are the signs and symptoms of a calcaneal fracture? You may have any of the following on your injured heel or foot:

• Bleeding or bone parts coming out from an open wound or hematoma (swelling filled with blood).
  
  
• Weakness or numbness (loss of feeling) on the foot.
  
  
• Pain, inflammation (swelling), tenderness, warmth, and redness on your heel and sole.
  
  
• Trouble moving or problems putting weight on the affected foot.

How is a calcaneal fracture diagnosed? A calcaneal fracture may be diagnosed with any of the following:

• 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 exactly where 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.

How is a calcaneal fracture treated? You may have any of the following:

• 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.
  
  
• Medicines: You may be given medicines to control pain. Antibiotic medicines may help prevent infection from germs. You may need to have a tetanus shot if there is an open wound. This is a shot of medicine to keep you from getting tetanus.
  
  
• 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 a closed reduction.

Where can I get more information? Having a calcaneal fracture may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont, IL 600184262
  Phone: 1-847-8237186
  Web Address: http://www.aaos.org/
  

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.

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