One of the most debilitating conditions we treat at Eagle-Summit Foot & Ankle is the heel fracture. These high-energy injuries—most often sustained due to falls from heights—can lead to arthritis of the rearfoot and ankle almost no matter what we do to fix it. This is because the heel bone is like an egg – when it breaks, it really breaks. The hard outer shell fragments and exposes the inside, which is a gooey, softer bone.
A break is never ideal, but the good news is that we can put the bone back in a better position with surgery.
For most high-impact calcaneal fractures, a large L-shaped incision is made along the outside of the back of the foot. This incision is made straight down to the bone, with care to maintain the surgical flap. The bone fragments are then put back in place utilizing a few different maneuvers to anatomically realign the pieces. A large plate with several screws is placed right against the bone to hold these tiny bone fragments in place.
Live x-rays, or fluoroscopy, are utilized to ensure all of the pieces are put back in place like a completed jigsaw puzzle. We take extra precautions to align the joint surfaces of the subtalar joint (the joint above the heel bone) and the calcaneocuboid joint (the joint just past it). If the cartilage here is already too badly-injured, or if the cartilage will not line up perfectly, a primary fusion of the joint is often the best procedure to prevent long-term arthritis. This locks up the joint, but prevents pain down the line.
Other, smaller heel fractures do exist and often still need surgical correction as well. Thankfully, aside from the risk of arthritis, long-term results are decent when fixed properly. If you have a fall from a height in Summit and Eagle Counties and end up with this painful injury, we at Eagle-Summit Foot & Ankle may be the ones to meet you in the emergency department or operating room. We’ll get you back on your feet as quick as we can!