A calcaneus fracture is a broken heel bone. Causes of a heel fracture typically include falls from a height, such as those which climbers may sometimes experience, and accidents involving motor vehicles. The degree of seriousness of a heel bone fracture can vary a lot, with minor cases requiring only to be immobilized, while a more severely broken bone may need to be treated surgically. A calcaneus fracture will generally be dealt with in an orthopedics department where doctors specialize in treating problems associated with bones and joints.
Although the calcaneus, or heel bone, is hard on the outside, the interior is relatively soft, with the result that the heel is the part of the foot that is most frequently broken. Swelling, pain, bruising and deformity may be seen at the site of a fracture, and typically a person will not be able to place any weight on the affected foot. If the bone breaks but the pieces stay in place, this means the injury is less serious. The associated pain might then be more of a dull ache, and treatment may only involve wearing a foot cast to prevent the heel and its joint with the leg from moving. It can take up to six months for such a fracture to heal.
Where a heel injury is more severe, and the various pieces of a calcaneus fracture have moved in relation to one another, the sections of bone will generally have to be fixed back together. In some cases a procedure known as a closed reduction may be carried out under general anesthetic. Here, the foot is manipulated from the outside to move the pieces of broken bone back into place, removing the need to open up the foot completely. Special surgical instruments are introduced through small incisions in the foot and used to insert fixing pins and wires. A type of X-ray called a fluoroscope is used to show the surgeon what is happening.
With a more complicated calcaneus fracture, what is called an open reduction will probably be used. This involves surgery to open up the foot and expose the broken bones, before fixing them together using metal pins and plates. Examples of these more complex fractures would include those which affect the joint between the heel and the leg, and those where the calcaneus is shattered into tiny pieces. In the case of a calcaneus fracture causing extremely serious damage to the heel joint, the joint may have to be fused together using special glue or screws.
