A fracture in the calcaneus, the heel bone, can cause great pain and significant limitation. This fracture most often occurs due to an energy-intensive high impact injury such as a car accident or a fall from a ladder, during which the heel is crushed under body weight. In cases of calcaneus fracture the heel may contort and shorten or dilate.
Fractures of the calcaneus can be quite severe. Their treatment often requires surgery to restore the normal anatomical structure of the heel and allow return to movement, in order to allow the patient to return to routine activities.
When should surgery be performed?
The initial treatment of heel fractures is usually performed in the emergency room and involves external fixation of the heel using a brace, plaster or a special boot, in order to prevent the aggravation of the injury. Not all fractures in calcaneus require surgery, and recovery from the fracture takes up to four months in most cases.
If part of the bone has moved as part of the injury, an orthopedic specialist may recommend surgery. If surgical treatment is required, it is usually possible to wait before the operation and perform it on an ambulatory basis, in order to allow the swelling around the fracture to subside before the procedure - a process that can take several weeks.
In cases of an open fracture of the heel - when the bone breaks through the skin - the treatment is exponentially of higher urgency and includes hospitalization for surgery as soon as possible.
The course of the surgery
Surgery to repair fractures in calcaneus can be performed in two main methods. One method is to return the bone parts to their normal structure in an open method, using an incision. Then, internal fixation is done by installing wires, plates and screws.
Another repair option is perforated fixation, using screws inserted through tiny incisions in the skin, without making additional incisions. Each approach is suitable for a different type of heel fracture, and the choice of method will be made according to the type of fracture and at the discretion of the surgeon.
The surgery is usually performed under general anesthesia and lasts a few hours.
Preparation for surgery
Prior to surgery, a thorough examination must be performed by an orthopedic specialist, and the preliminary examinations performed along with medical records must be examined. Sometimes it is necessary to perform additional tests before the surgery in order to plan the most appropriate route for each patient.
It is important to bring the letter of release from the original screening and the xrays, if any, for examination.
An anesthesiologist should be consulted if the surgery is performed under general anesthesia. It is mandatory to be on a full food fast according to staff instructions.
Recovery after the procedure
Swelling and heel pain after surgery are quite common. Recovery from calcaneus surgery may take a long time, during which it is important to perform rehabilitation to prevent recurrent or additional injuries and improve leg function and ankle movements. Gradual rehabilitation will be implemented according to the recommendations of the surgeon, and at least part of the time through physical therapy.
If necessary and depending on the pace of recovery, painkillers can be used to allow better rehabilitation of the foot, while paying close attention and maintaining awareness for personal limitations and pain.
Possible complications
Heel fractures are accompanied by complications that are difficult to prevent even through surgery. Among other things, nerve and tendon damage, joint stiffness and chronic pain or swelling can develop. In rarer cases, an infection, difficulty in healing of the wound or arthritis resulting from injury can develop.
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