Calcaneal Fracture Fixation

What is Calcaneal Fracture Fixation?
Fractures of the heel bone, or calcaneus, can be disabling injuries. They most often occur during high-energy collisions — such as a fall from height or a motor vehicle crash. Because of this, calcaneus fractures are often severe and may result in long-term problems.

The calcaneus is the most frequently fractured tarsal bone. Tarsal bone fractures account for about 2% of all adult fractures. Of these, 60% are calcaneus fractures.

A calcaneal fracture fixation is an operation that returns the fractured bone fragments to their normal alignment so that they can heal.

Treatment
The following procedures are used for calcaneal fracture fixation treatment:

Open reduction and internal fixation. During this operation, the bone fragments are first repositioned (reduced) into their normal alignment. They are held together with special screws or metal plates and screws.

Percutaneous screw fixation. Sometimes, if the bone pieces are large, they can be moved back into place by either pushing or pulling on them without making a large incision. Special screws can be placed through small incisions to hold your bone pieces together.

Recovery Time
Bones have a remarkable capacity to heal. The more severe your injury, however, the longer your recovery may be. Patients with more severe fractures are also more likely to suffer some degree of permanent loss of function, regardless of treatment.

How long it takes to return to daily activities varies with different types of fractures. It depends on the severity of the injury. Some patients can begin weight-bearing activities a few weeks after injury or surgery; some patients may need to wait three or more months before putting any kind of weight on the heel.

Early motion. Many doctors encourage motion of the foot and ankle early in the recovery period. Patients who have had surgery are instructed to begin moving the affected area as soon as the wound heals to the doctor’s satisfaction.

Physical therapy. Specific exercises can improve the range of motion in your foot and ankle, and strengthen supporting muscles. Although they are often painful at the beginning and progress may be difficult, exercises are required in order for you to resume normal activities.

Weight-bearing. When you begin walking, you may need to use a cane and wear a special boot. It is very important to follow your doctor’s instructions for walking on your foot. If you place weight on your foot too soon, the bone pieces may move out of place and you might require surgery. If you have had surgery, the screws might loosen or break and the bone may collapse. This may not occur the first time you walk on it, but if the bone is not healed and you continue to walk on your foot, the metal will eventually break.

Smoking affects both bone and skin healing, so it is important to tell your doctor if you smoke. Some surgeons will not perform surgery on a patient who smokes, because of the increased risk of serious complications. Even without surgery, your bone may take longer to heal if you smoke.

Additional surgery is usually required in cases of infection or difficult wound healing. If all methods of solving the problem have failed, amputation may be considered.