Fractures of the calcaneus (heel bone) are the most common tarsal bone fracture.
Most calcaneal fractures occur as the result of a fall from a height greater than 14 feet. Calcaneal fractures are common among roofers and rock climbers. The second most common contributing cause to these traumatic fractures is automobile accidents. Calcaneal fractures are most commonly found in male’s age 30-50 y/o.
The diagnosis of calcaneal stress fractures can be difficult at times because they don’t always show up on x-rays. Quite often, the only x-ray findings that we'll see are those signs that show up towards the end of the healing process, sometimes as long as several months after the onset of the injury. Persistent pain may indicate the use of an MRI or CT scan to locate the fracture.
Pain and swelling are the most common symptoms. Tight muscles around the heel can also be inflamed.
Calcaneal fractures come in all shapes and sizes. Some are quite obvious and severe while others are less obvious and more difficult to diagnose. The symptoms of a calcaneal fracture following a fall include:
(1) inability to bear weight on the heel
(2) swelling of the heel and
(3) bruising of the heel and ankle. Symptoms of calcaneal stress fractures may persist for 6 months or more.
The treatment for a heel fracture can vary from a period of rest, to complete immobilization. Treatment options include hard casts or removable walking “boots”. The duration of symptoms and time necessary for adequate healing varies with the age, nature of the fracture and general health status of the fracture. It is not unusual to find calcaneal fractures that are symptomatic up to 4-6 months post injury.
Occasionally heel fractures will require surgical intervention. Sometimes it is necessary to pin the bones together to aid in healing. Remember, you have a lot of weight on your heels and we need to make sure the bones provide adequate support.