Physiopathology:

The calcaneus connects with the talus and cuboid bones. Calcaneus is the heel bone, major weight-body support. He is involved into subtalar joint (calcaneus/talus) and calcaneo-cuboid joint. When calcaneus fracture involves joints (intra-articular fracture), it is a more severe case because it involves cartilage damage, factor risk of future osteoarthritis . When calcaneus is broken, the bone tends to collapse. It occurs in most of cases during severe traumas like falling from a height or during automobile accidents but every kind of injury can be concerned. Sometimes, it can be stress fractures, caused by overuse on the heel bone.

Clinics

TRAUMATIC FRACTURES:

•          Acute heel’s pain with inability to bear weight

•          Swelling

•          Bruising/ hematoma

STRESS FRACTURES:

•          Heal pain with progressive worsening

•          Heel’s swelling

X-rays and other imaging tests like CT are commonly required to provide adequate therapeutic advise.

Conservative measures:

•    Rest

·      Ice, without direct contact with skin

·      Compression with an elastic device

·      Elevation with the heart level.

·      Immobilization: cast / walking boot/ crutches in case of “without weightbearing” advice.

Surgical treatment for some traumatic fractures:

Bone architecture & Joint reconstruction; joint fusion is indicated for the more severe cases. The surgeon will choose with you the best approach.

Physiotherapy & Prognosis:

The outlook for recovery (strentght, function) depends on fracture’s severity. It may be the beginning of chronic problems because of fracture’s severity:  pain, arthritis, stiffness are frequent complications. Ability to walk may be compromised with a limp in case of loss of calcaneus’s height. In some cases, an orthotic device will be advised: custom insoles with medial arch surelvation and height’s loss compensation. Surgical treatment to make a joint fusion may be case advised in case of chronic painful osteoarthritis.

Dr. Benjamin Fedida, MD

Orthopedic Surgeon