Initial Treatment for Calcaneal Fractures
Many fractures of the heel bone are complicated by significant swelling. To bring the swelling down and facillitate healing of the tissues, first aid treatment of the fracture includes:
- Protect your injured foot from further injury.
- Rest: Stay off the injured foot. Walking may cause further injury.
- Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Compression: An elastic wrap can be used to control swelling (but only allow a professional to apply a compression bandage, as inappropriate compression can impair blood supply).
- Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.
These simple measures are often very effective.
Treatment in the Hospital
Treatments for calcaneus fractures depends on the type and severity of the fracture. If the fracture is not severe, a cast can be used to immobilise the foot and allow the bones to heal. More often, surgery is required.
Types of surgery for calcaneal fractures include:
- Plates and screws to fix the bones in place
- Arthrodesis (fusion). This type of surgery is dramatic and only recommended for severe fractures, or when other types of surgery have failed. Arthrodesis is very good at stabilising joints, but reduces the range of movement. If the joints around the calcaneus are fused in place, the normal stressors placed on the bones during walking changes. This can lead to arthritis and difficulty walking later in life.
For more information on treatment see Surgery for Calcaneal Fractures.
How long will the fracture take to heal?
If everything goes well and the fracture is relatively uncomplicated, the heel bone should take eight to twelve weeks to become solid bone. Over the following months the bone wil continue to strengthen into near-normal bone.
However, complicated fractures, especially in those cases where the bone has shattered rather than just broken will take longer. Furthermore, fractures that become infected will need further treatment and may take much longer.
What about rehabilitation and physiotherapy?
It is important to remember that the bone may heal well, but the other structures around the ankle, including the tendons, muscles and especially the fatty heal pad may take months to heal. This includes the less severe fractures that do not require surgery - wearing a cast for a number of weeks will cause the muscles and tendons to become weak and stiff.
Rehabilitation can consequently cover weeks to months after the surgery or, if no surgery was performed, removal of the cast. Your physio will be able to discuss the need to keep the muscles around your joint strong and flexible.