Calcaneus Fracture Surgery
CALCANEUS FRACTURE SURGERY
CALCANEUS FRACTURE SURGERY
The calcaneus is the heel bone. Fractures or breaks of the calcaneus commonly occur after a fall from a height or car accident. Treatment of these fractures may require surgery.
The goal of heel fracture surgery is to restore the shape of the heel bone as close to normal as possible. Restoration of normal alignment and contour is considered the best way to restore function and minimize pain.
Not all heel fractures require surgery. If the shape of the calcaneus is generally maintained, surgery may not be needed. Patients with diabetes may be at increased risk for infection or wound healing problems. Patients with poor blood flow may also have difficulty healing properly. Elderly individuals may have difficulty with surgical rehabilitation.
Heel surgery often is delayed due to the swelling that typically accompanies these injuries. It may be severe enough to delay surgery for weeks or preclude it altogether. Surgery can safely proceed when the skin at the surgical site at the lateral heel wrinkles, indicating the dangerous swelling has gone away.
SURGERY
The most common surgical techniques utilized to treat a broken heel bone involve cutting through the skin to place the bone back together and using plates and screws to hold the alignment until the bones heal. A classic "open" procedure involves an incision over the lateral aspect of the heel. The incision is likened to a hockey stick or large “L” where the overlying nerve and tendons are moved out of the way. The fracture fragments are restored to the best possible position and a plate and screws hold the fragments in place.
The technique of "closed" reduction and percutaneous fixation can sometimes be utilized. Multiple small incisions are placed in critical areas around the heel. The broken fragments can be realigned with the help of X-rays. Screws are then placed through the skin to hold the position.
The size and location of the incision and the type of screws and plates used are based on skin quality and the surgeon’s judgment on how to best access and fix the broken fragments of bone.
COMPLICATIONS
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.
Complications from treatments for displaced calcaneus fractures can be severe. The most common early complications are in skin healing and nerve stretch. Most wound healing complications can be treated with wound care. Occasionally further surgical treatment may be required. The development of a deep wound infection often requires surgery and antibiotics. Nearly all nerve stretch complications will resolve over time.
FREQUENTLY ASKED QUESTIONS
Information provided by American Orthopedic Foot and Ankle Society (AOFAS) via FootCareMD.com