Calcaneal Fracture

A fracture is a break in the bone. The calcaneus is the large irregular bone in the foot that makes up the heel of the foot. This bone can be fractured in many ways. There are many different ways of treating these fractures. There is not universal agreement on the treatment of these fractures and there is often more than one way of treating these fractures, all of which can be correct.

TREATMENTS

Calcaneal fractures can be treated with:

  • Immobilization, which means the fracture is casted as it is without changing the positions of the fracture (bone pieces) involved.

  • Closed reduction, in which the bones are manipulated back into position without opening the site of the fracture (break) using surgery.

  • ORIF (open reduction and internal fixation), in which the fracture site is opened and the bone pieces are fixed into place with some type of hardware (for example, screws, pins or plates).

  • Primary arthrodesis (fusion), which means that the joint has enough damage that a procedure is done as the first treatment which will leave the joint permanently stiff. This will decrease function, however usually will leave the joint pain free.

Your caregiver will discuss the type of fracture you have and the treatment that will be best for that problem. If surgery is the treatment of choice, the following is information for you to know and also let your caregiver know about prior to surgery.

LET YOUR CAREGIVERS KNOW ABOUT:

  • Allergies.

  • Medications taken including herbs, eye drops, over the counter medications, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or novocaine.

  • A family history of anesthetic complication.

  • Possibility of pregnancy, if this applies.

  • History of blood clots (thrombophlebitis).

  • History of bleeding or blood problems.

  • Previous surgery.

  • Other health problems.

AFTER THE PROCEDURE

After surgery, you will be taken to the recovery area where a nurse will watch and check your progress. Once you are awake, stable, and taking fluids well, barring other problems you will be allowed to go home. Once home an ice pack applied to your operative site may help with discomfort and keep the swelling down. Elevate your foot above your heart for the first 7-10 days after surgery. Do this as much as possible.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's instructions as to activities, exercises, physical therapy, and driving a car. Do not drive a car until your caregiver specifically tells you it is safe to do so.

  • Use crutches as directed by your caregiver.

  • Daily exercise is helpful to prevent return of problems. Maintain strength and range of motion as instructed.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Be certain to make all of your follow-up appointments. This is critical for optimal healing.

SEEK MEDICAL CARE IF:

  • Increased bleeding (more than a small spot) from the wound or from beneath your cast or splint.

  • Redness, swelling, or increasing pain in the wound or from beneath your cast or splint.

  • Pus coming from wound or from beneath your cast or splint.

  • An unexplained oral temperature above 102° F (38.9° C) develops.

  • A foul smell coming from the wound or dressing or from beneath your cast, splint or removable fracture boot.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a rash, have difficulty breathing, or have any problems which seem to be from an allergy.

  • You develop swelling or inability to move your foot or toes.

  • You develop tingling or numbness in your foot or toes.

  • Your foot or toes turn blue, pale or cold.

  • You develop severe pain in the area of your injury.

If you do not have a window in your cast for observing the wound, a discharge or minor bleeding may show up as a stain on the outside of your cast. Report these findings to your caregiver. If you have been given a removable fracture boot, a small amount of bleeding through the dressings is normal. Change the dressings as instructed by your caregiver.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.