As we discussed in an earlier post
, calcaneal fractures usually occur when a person’s heel absorbs a large amount of stress. Oftentimes people fracture their heel when they fall from great heights, so around this time of year it’s not uncommon for a few hunters to end up on my table because they fell out of a tree stand. Today, we’ll examine the treatment options for calcaneal fractures, and how fast you can expect to be back on your feet.
Non-surgical treatment used to be considered the safest option, but as surgical procedures have improved, more patients are opting to go under the knife.
In some minor cases where the broken bone has not been displaced, a doctor may decide that the patient can get by with casting or another immobilization technique, but even then complications can arise. Without surgery, your heel may be susceptible to widening. When that occurs, the subtalar joint can become arthritic, tendons can deteriorate over time, and surrounding joints can develop complications due to increased stress.
Non-surgical treatment is conducted by immobilizing the foot for eight weeks. The patient is not allowed to put any weight on the foot at this time. This process is not ideal, and almost all non-displaced fractures are treated surgically.
Surgical treatment of calcaneal fractures can help address both displaced and non-displaced fractures. Oftentimes the heel is prone to swelling after the injury, so your doctor may wait to preform the operation until it subsides. This process can be expedited by keeping your leg immobilized and elevated.
The surgical procedure consists of two main components:
- Creating a small incision to access the injured area; and
- Placing the broken fragments back in the correct location, and stabilizing the bone using small plates and screws.
The wound healing rates for these types of minimally invasive procedures are astounding.
After the operation, patients have their foot placed in a splint for two weeks. After that, I transition them to a removable cast boot. This minimally invasive procedure allows patients to begin weight bearing at six weeks, two weeks earlier than the non-surgical procedure.
Rehabilitation also progresses quicker if the patient undergoes a surgical operation. That said, make sure you heed your doctor’s orders, as rehabbing too quickly or putting too much weight on the affected area could cause the bones or the metal plates to break. Your doctor will likely recommended that you see a physical therapist once your injury progresses to the point that you can bear moderate or the majority of your weight.
Related source: AAOS