Heel fractures, which are also known as Calcaneus fractures, can be severe and disabling. These fractures commonly happen during a high-energy or impact event such as falls, car crashes or sports injuries. They occur when the weight of the body is too much for the heel support. Treatment often involves surgery but some fractures lead to long-term complications.

Anatomy

The bones of the feet are split into three categories: the hindfoot, midfoot and forefoot. The tarsals make up the hindfoot and midfoot. The heel bone (calcaneus) is the largest of the tarsal bones in the feet. Together, the heel bone and the talus form the subtalar joint. This joint allows side-to-side movement and balance.

Causes of Fracture

Fractures of the heel bone are uncommon. These fractures can occur due to a fall from a height, a car crash or a twisting injury to the ankle. If fractured, it’s possible for the heel bone to widen or shorten. The severity and damage done by a fracture can vary, and depends on several factors including:

• The number of broken bone fragments
• The size of the fractures
• The number of fractures
• The extent of displacement of each piece of bone
• The injury to the surrounding soft tissues

If the bone breaks fragments stick out through the skin, the break is considered an open fracture. These types of fractures take longer to heal and cause more damage to the surrounding soft tissue. They also have a higher risk for infection.

Symptoms

Patients with heel bone fractures typically experience bruising, swelling, heel deformity, pain and are unable to put weight on their heel. Minor fractures won’t inhibit your ability to walk but the more severe the fracture the harder it is to be mobile. The Achilles tendon works with the calcaneus to support your body weight. If you heel bone is severely damaged by the injury your muscles and tendons can’t produce enough power to support your weight as you walk. This will lead to instability when moving.

Treatment

Most heel bone fractures cause the bones to widen and shorten, so typically the goal of treatment is to restore the anatomy of the heel. Nonsurgical treatments are recommended if the broken bone was not displaced by the injury. Patients can expect to wear a cast for 6 to 8 weeks or longer. You won’t be able to put any weight on your feet until the bone is healed.

Surgery that repairs a heel bone fracture can restore the shape of the bone but sometimes leads to complications. Wound healing problems, infections and nerve damage are all common pre and post surgery. A doctor will review the full details of your injury and discuss the risks associated with both a surgical and nonsurgical approach to your fracture.

For more information on heel bone fractures visit:

American Academy of Orthopaedic Surgeons