Calcaneal injuries are challenging fractures for orthopedic surgeons to manage. The calcaneus, otherwise known as the heel bone, is the most commonly injured bone in the foot. This bone is usually fractured by falling from a high point and landing on the heel. I hear many stories of how patients injure their calcaneus. Here are some of the most common:
- Falling out of a deer stand
- Jumping off a roof
- Slipping off a ladder
In the past, non-surgical treatment was considered safest as the risks from wound healing were so problematic and infection rates so high. However, without surgery, the heel widens and the foot cannot fit inside a normal shoe, the subtalar joint becomes arthritic, uneven ground becomes painful to walk on, and eventually the tendon will tear. And that’s just the beginning! Eventually the ankle and hindfoot joints will develop arthritis from the excessive stress. Today, almost all but non-displaced fractures are treated surgically to decrease these complications.
In the past, surgeons used to keep the patient in a splint for 10-21 days after the fracture before doing surgery. Following the procedure, patients were kept casted and non-weight bearing for 10 weeks.
Using the minimally invasive approach, I can safely fix these fractures within a few days of the injury. Using small incisions I align the fracture fragments and the joint surface to recreate the shape of the heel bone. Then I gently slide plates underneath the skin and place screws to rigidly stabilize the bone. The wound healing rates are phenomenal and patients marvel at how small the incision is. Patients are kept in a splint for only 2 weeks and then transitioned to a removable cast boot. Because fractures heal faster with minimally invasive techniques, I let my patient bear weight after only 6 weeks. Rehabilitation is faster, easier, and the results are simply better.
