What is a calcaneal fracture? A calcaneal fracture is a broken bone involving the calcaneus or heel bone. Calcaneal fractures typically occur after a fall from a height or a motor vehicle accident.
What should I do if I think I may have fractured my calcaneus?
If you are unable to bear weight on the injured foot , you will require an X-ray as soon as possible. A large bruise on the heel, called a Mondor’s sign, is another symptom of a calcaneal fracture. You should be evaluated by an emergency room or urgent care physician . It is important that compartment syndrome, a serious complication cause d by internal pressure build up, is ruled out. Once it is determined that compartment syndrome is not present and there has been no damage to any nerves or blood vessels, i t is important that a splint be applied as soon as possible to control swelling. Any lacerations in the skin from the fracture increase the risk of infection and also needs to be treated promptly .
Do all calcaneal fractures require surgery?
The majority of calcaneal fractures do require surgery. Several factors are taken into consideration when determining whether the best course of action is surgery or conservative care. It is imperative to restore the shape of the calcaneus as well as possible to minimize pain and restore function . Most of the time, if calcaneal fractures are not treated with surgery, the calcaneus will be flattened and there will be collapse of the subtalar joint. If the calcaneus is allowed to heal in this position, you will typically develop pain in the front of your ankle when walking due to impingement.
What would conservative care treatment consist of?
In general, conservative treatment consists of imm obilization of the injured calcaneus . Many factors determine whether or not you can be weight bearing in a walking cast vs. non-weight bearing with crutches, walker, or a scooter.
How are calcaneal fractures repaired surgically?
The bone fragments of the calcaneus are manipulated back into their an atomic position and stabilized with screws , plates, and/or pins which are placed in the bone and remain under the skin. A CT scan will typically be needed for surgical planning. All calcaneal fractures regardless of treatment modality require routine follow-up with a foot and ankle specialist to monitor progress and ensure the fracture is healing well in the proper alignment.
C an ankle fractures lead to subtalar joint arthritis?
No matter how well the calcaneus is restored to its normal shape after surgery, arthritis of the subtalar joint is very common. Most of the time, patients will have their subtalar joints surgically fused at some point after sustaining a calcaneal fracture. However, if the architecture of the calcaneus can be restored prior to this, the procedure is much less involved. If the architecture of the calcaneus is not restored, a different type of a fusion with a large bone graft is typically required. Contact us to make an appointment for your calcaneal fracture today.
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