Expert Diagnosis & Treatment for Heel Fractures

Causes of Heel Fractures

The heel bone is large and dense, and not as prone to fracture as some of the smaller bones in the feet. However, tiny cracks or stress fractures may occur with repetitive use from athletic activities such as basketball, dancing and long-distance running. More serious fractures of the calcaneus are usually caused by traumatic injury due to car accidents, blunt force or falls from a great height, such as from a roof or ladder.

Signs & Symptoms of a Calcaneus Fracture

A serious fracture of the heel bone will usually cause immediate symptoms, including:

• Sharp or throbbing pain in and around the heel bone.
• Swelling and bruising at and around the injury site.
• Pain that increases with any weight-bearing activities and is relieved by rest.

Diagnosis & Treatment of Heel Fractures

If you have sustained an injury to your foot and have symptoms that suggest a heel bone fracture, you should be evaluated by an orthopedic specialist as soon as possible. Untreated, heel fractures can cause further damage to the foot and joints and lead to chronic pain and disability.

In addition to a physical exam of the foot and ankle, evaluation and diagnosis may include:

• X-ray of the foot.
• CT scan of the foot if a fracture is confirmed on X-ray.
• Calcaneal squeeze test in which the heel bone is gently squeezed from both sides. If painful, it may indicate a stress fracture.

Treatment of a heel fracture most often consists of rest; icing to reduce swelling; and immobilization with a splint, medical boot or partial cast to protect the foot from further injury. Anti-inflammatory medications may also be recommended.

Although rare, in some cases, severe heel fractures may require surgery. If the bones are visibly pressing against the skin, surgery is almost always required.

Surgical Repair of Heel Fractures

After the swelling has gone down, an incision is made along the outside part of your foot over the heel bone. The orthopedic surgeon will maneuver the bone fragments back into the right place and secure them in position with metal plates and screws.

Regular follow-up visits will be scheduled to ensure the wound is healing well and not showing any signs of infection. Once the bones heal, which can take 3-4 months or more, the metal plates and screws may or may not be removed.

Recovering from a Heel Fracture

The time it takes to recover will depend on the severity of the fracture and whether surgery is necessary. Minor stress fractures with little muscle involvement may allow you to resume normal activities after 3-4 months while more severe injuries can require a much longer recovery period.

With or without surgery, recovery will likely include the following:

• Immobilization of the foot with a splint or medical boot.
• Avoidance of weight-bearing activities.
• Prescription or over-the-counter anti-inflammatory medications.
• Physical therapy.

Potential Complications of a Fractured Heel

With or without surgery, there are several potential long- and short-term complications that may develop even after a heel fracture has been treated. These include:

• Incomplete healing.
• Persistent stiffness in the foot or ankle.
• Pronounced limp and/or decreased mobility.
• Lingering pain when weight-bearing.
• Increased risk for arthritis in the affected foot.
• Nerve irritation around the surgical site.
• Chronic swelling.