What are the other Names for this Condition? (Also known as/Synonyms)

• Broken Heel Bone
• Broken Calcaneus
• Fractured Calcaneus

What is Calcaneus Fracture? (Definition/Background Information)

• A Calcaneus Fracture is a disabling injury that occurs when one or more bones of the heel, fractures. Hence, this fracture is also known as a Heel Bone Fracture (of the calcaneus)
• These fractures are usually caused by a high-energy impact that results from an athletic sport, a motor vehicle accident, or a fall from a substantial height
• On an average, this injury predominantly seems to occur in male individuals, between the ages of 30-50 years

Who gets Calcaneus Fracture? (Age and Sex Distribution)

• Calcaneus Fractures are non-specific fractures, and as such, may occur in individuals of any age, race, ethnic group, and gender
• Young athletes (who participate in high-impact sports), men in the 30-50 year age group, all have a high rate of occurrence
• Men are 5-times more likely to experience this injury, than women

What are the Risk Factors for Calcaneus Fracture? (Predisposing Factors)

Common risk factors associated with a Calcaneus Fracture include:

• Participation in high-risk contact sports, such as football, basketball
• Middle-aged men between the ages 30 and 50 years, are a high-risk group

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Calcaneus Fracture? (Etiology)

Some of the causes of a Calcaneus Fracture include:

• Falling from a significant height; especially landing on one’s heels (or the fracture occurring since the individual is overweight)
• Automobile accidents
• Taking part in any rough or high-impact sport

What are the Signs and Symptoms of Calcaneus Fracture?

Signs and symptoms of a Calcaneus Fracture include:

• Severe and immediate pain at the site, where the injury occurred
• Swelling; tender sensation to touch
• Noticeable bruising, abnormal deformity of the heel
• Inability to apply weight, or bear any pressure on the foot

How is Calcaneus Fracture Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Calcaneus Fracture include:

• Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, in the foot. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray: X-rays are the most common methods to evaluate a fracture, especially if the bone has been displaced. This diagnostic test will provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture
• Computerized tomography (CT) scan: A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues of the body, which then allows a physician to examine the foot and surrounding structures
• Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field to generate thorough images of the interior bones and soft tissues
• Bone scan: A bone scan is a diagnostic method used to identify any bone abnormalities. It is performed by injecting tiny amounts of radioactive material into the bloodstream

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Calcaneus Fracture?

Complications associated with a Calcaneus Fracture include:

• Degenerative joint disease (osteoarthritis)
• Osteonecrosis: A serious disorder characterized by a temporary or permanent disruption of blood flow to the bones
• Prolonged and chronic pain
• Infection of the bone (osteomyelitis)
• Permanent disability of the foot
• Permanent damage to nerves and blood vessels
• Abnormal pressure build-up within the muscles of the foot that reduces blood flow, preventing oxygen and nourishment from reaching the nerve and muscle cells (termed as compartment syndrome)

How is Calcaneus Fracture Treated?

A high percentage of Calcaneus Fractures require surgery. However, this injury may also be treated non-surgically. Nonsurgical treatment methods include:

• Any activity that aggravates the foot condition should be avoided. The physician may advise the individual to refrain from participating in any physical activities, till the pain or symptoms get better
• Applying ice to the foot/heel can help reduce pain and swelling
• Complete immobilization of the foot with a cast, may be required to restrict movement
• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to treat a Calcaneus Fracture. These medications can help decrease the pain and swelling
• Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the foot muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality

Surgical treatment methods include:

• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin
• Percutaneous screw fixation: Percutaneous screw fixation is another surgical procedure meant to realign a fracture into its original position, without making a large incision. This procedure is usually performed if the fractured pieces of the bone are large enough

How can Calcaneus Fracture be Prevented?

To prevent a Calcaneus Fracture, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or Calcaneus Fractures include:

• Individuals who participate in any high-risk sports, should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size), may help prevent accidents
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Calcaneus Fracture. For women, the recommended amount of calcium, increases with age and menopause
• Perform weight-bearing exercises to strengthen bones

What is the Prognosis of Calcaneus Fracture? (Outcomes/Resolutions)

• A high percentage of Calcaneus Fractures heal without any serious complications
• A full recovery and a return to sports or normal daily activities usually requires a few weeks to months, depending on the severity of the injury
• When properly treated and rehabilitated, usually under the guidance of a physiotherapist/specialist, a high percentage of individuals regain their full strength and range of motion in the injured leg

Additional and Relevant Useful Information for Calcaneus Fracture:

• The calcaneus bone is the most commonly fractured tarsal bone of the foot
• Approximately 2% of all adult fractures occur to one of the tarsal bones. It is observed that at least 60% of those fractures include the calcaneus bone