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Open Reduction and Internal Fixation of a Calcaneus Fracture


  • Open reduction (re-DUK-shun) and internal (in-TER-nal) fixation (fik-SA-shun) (ORIF) of a calcaneus (heel) fracture is surgery to fix a broken calcaneus bone. The heel bone is the largest and most frequently broken bone of the foot. The heel bone supports the weight of the body while walking and standing. Athletes, soldiers, and obese (very overweight) persons have higher risk of breaking their heel bone. ORIF is done when the fracture is large, or when the bones are broken into several pieces. It may also be done if the nerves, ligaments, and blood vessels are also damaged.
  • With ORIF of a calcaneus fracture, special screws, pins, and plates are used to put the broken bones back together. These tools are used to hold the bones in place while they heal. Your caregiver may also place new bone into the spaces between or around the fracture. A cast or splint may be used after surgery to protect and limit movement on the affected foot. You may be asked to limit activities until your foot heals. With ORIF, your calcaneus fracture may be treated and usual activities and sports may resume as soon as possible.


Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
  • Pain medicine: You may need medicine to take away or decrease pain.
    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Caring for your wound:

Wounds must be free from germs, such as bacteria and viruses, to help them heal. Do the following to help your wound heal:

  • Do not let your wounds get wet. Always keep your wounds clean and dry. When you are allowed to bathe or shower, carefully wash the wound with soap and water. Afterwards, pat it dry with a clean towel. Ask your caregiver what else you should do to care for your wound.
  • Limit movements, such as stretching, to prevent bleeding, tearing, and swelling.

Cast or splint care:

You may need a cast or splint to keep your foot from moving while it heals. You may take a bath when your caregiver tells you it is OK. It is important not to get the cast or splint wet. Before bathing, cover the cast or splint with two plastic trash bags. Tape the bags to your skin above the cast to seal out the water. Keep your foot out of the water in case the bag leaks. Ask your caregiver for more information on cast and splint care.

Other ways to help bones and wounds heal:

  • Eat foods high in protein, such as meat, eggs and dairy products, to help repair tissues. Carbohydrate-rich foods, such as bread and cereals, are needed for cell growth. Eating foods high in calories, and foods rich in zinc, such as meats, seafood (especially oysters), and liver, may also help healing. Taking vitamins A and C help increase scar tissue strength. Caffeine causes blood vessels to constrict (get small). This carries less oxygen to body tissues and delays healing. Caffeine may be found in coffee, tea, soda, and sports drinks. Ask your caregiver for more information about foods that may help wound healing.
  • Avoid smoking cigars, pipes and cigarettes. Smoking decreases the ability of new blood vessels to form on the wound site, and delays healing.
  • Certain medicines, such as steroids and blood thinners, may delay wound healing. Ask your caregiver for more information about medicines that may delay healing.
  • If you have certain diseases, such as diabetes (high sugar level in the blood), take your medicines regularly, and carefully control your blood sugar. People with diabetes may have poor wound healing. Ask your caregiver for help managing your diabetes.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Using crutches:

You may need to use crutches for support and decrease the stress on your foot when walking. It is important to use crutches correctly. Ask your caregiver for more information about how to use crutches.


  • You have a fever.
  • There are new blood stains or a bad smell coming from under the cast.
  • You have more pain or swelling than you did before the cast or splint was put on.
  • You have chest pain or trouble breathing that is getting worse over time.
  • You have questions about your medicine or care.


  • You have increased pain that does not go away.
  • Your cast breaks or gets damaged.
  • Your leg or toes feel numb.
  • Your skin or toenails near the injured heel become swollen, cold, or turn white, blue, or gray.
  • Your bandage becomes soaked with blood.
  • You suddenly feel lightheaded and have trouble breathing.
  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Open Reduction and Internal Fixation of a Calcaneus Fracture (Aftercare Instructions)

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