1. These Are High-Energy Injuries
The calcaneus is the heel bone. It is a thick bone to which the Achilles tendon attaches. To break this bone requires a lot of energy. Therefore, these fractures typically occur from motor-vehicle accidents or falls from a certain height (off a ladder or roof).
2. Always Check the Back
Especially with falls off ladders, the natural tendency is to try to land on your feet. This is the mechanism that breaks the calcaneus in the first place. But sometimes the force of the landing is transmitted up to the spine. There can be fractures of the lumbar vertebrae as well. Because the heel hurts so much, the back can get overlooked. So if you have back pain as well, be sure to tell your doctor.
3. Stay Off of It
Get crutches so you don't keep putting weight on the heel, which may cause further damage. Elevate the leg above the heart. These fractures can swell up quite a bit. Ice can also help with the swelling. Either a splint or a bulky compression dressing may be placed around the heel to prevent further motion and to allow the inflammation to subside. Some fractures can be treated without surgery, in which case the bulky dressing may be continued for about 6 weeks. After that, a boot or removable splint may be used to provide some support while you regain some motion.
4. Surgery May Be Required
Depending on the type of fracture, surgical stabilization may help to improve alignment. Usually, a plate and screws are used on the lateral (outside) portion of the heel. Even with surgery, the bone can take up to 3 months to heal. One of the big risks of surgery is infection. There is not much skin overlaying the bone, so one of the risks of surgery is that the skin breaks down and the bone becomes infected. Conditions that hamper circulation or weaken the immune system place you at higher risk. Smoking and diabetes are two common risk factors.
5. You Are Usually Never the Same
Because the calcaneus is right under the talus bone, the subtalar joint is usually affected. This is the joint that moves your ankle sideways. Fractures of the calcaneus usually affect this joint. Even with surgical fixation, the joint may be stiff afterward. Usually, the calcaneus is shortened from the fracture, which may cause the bone of the ankle to hit upon the shoe counter (the hole where you slide your foot in). A heel lift may help prevent this impingement. But overall, this is a bad injury.
