The calcaneus, or heel bone, consists of an extremely tough outer layer of bone material surrounding a spongy, softer interior. This combination creates a bone that is simultaneously quite difficult to break, and difficult to repair once broken. Relieving the pain from a broken calcaneus requires short-term care to reduce the swelling associated with injury, and damage repair to avoid permanent deformity and disability.
Recognizing Calcaneus Damage
According to the American Academy of Orthopaedic Surgeons, breaks of the calcaneus are commonly associated with falls from a significant height or motor vehicle accidents. For this reason, there is a good chance you will sustain additional injuries at the time of damage, and your doctors will need to distinguish your broken heel from other sources of pain. Typically, your pain symptoms will center on either the outside of your ankle or on the pad of your heel. You may also experience significant swelling and stiffness. In addition to these signs, a classic symptom of a calcaneus break is the inability to bear weight on the affected foot. If you suffer a hairline fracture rather than a traumatic break, these symptoms may manifest slowly over a number of days or weeks.
Treating Non-severe Breaks
If your injury is not severe, the first step in treatment typically involves a period of waiting while soft-tissue swelling in the area reduces. To encourage this process, your doctor will likely follow a common protocol of rest, ice, compression and elevation (RICE). This requires staying off your injured foot, treating it at regular intervals with an ice pack or other cold source, wearing a compression bandage or specialized stocking, and keeping elevated at or slightly above the level of your heart. Your doctor may also immobilize your foot with a splint or cast to allow further healing.
Treating Extensive Injuries
If the interior of is relatively intact, RICE treatment and immobilization are frequently sufficient to provide pain relief and proper recovery. However, if the bone interior is significantly deformed, or if the nearby joint within your foot is also injured, you may require additional surgical or nonsurgical intervention to avoid any future development of chronic pain.
Nonsurgical intervention involves a technique called a closed reduction. In this procedure, your orthopedic surgeon will physically manipulate the position of your calcaneus from the outside while you are under general anesthesia. If this method is ineffective, or the break in your bone is severe, your injury will require a surgical repair. Typically, surgery begins with the removal of any dead tissue. This is followed by the placement of plates or screws to secure the fragmented sections of bone. As an alternative, your surgeon may insert stabilizing pins or screws directly through your skin into the interior of the calcaneus.
Outcomes
Long-term relief of calcaneus pain depends upon the success of your procedure. Surgical repair is effective in 70 to 80 percent of relatively uncomplicated cases. However, these numbers drop sharply when numerous bone fragments are present. See your surgeon for more details.
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