Calcaneus Fracture


Most commonly fractured tarsal bone

MECHANISM

DIAGNOSIS

TREATMENT

  Initial Treatment
Splint type & position Body compression dressing
Initial follow-up visit Within 7 days for definitive casting
Pt instructions Non-weight bearing for 48 to 72 hours
Icing and elevation are important to reduce swelling
Active ROM of the foot and ankle as soon as pain permits
  Follow-up Care
Cast or Splint type & position Anterior or medial or lateral process: SLWC
Tuberosity: SLNWBC, 5 to 10 degrees equinus
Sustentaculum tali: SLNWBC
Body: no immobilization, active exercise
Length of immobilization Anterior or medial or lateral process: 4 weeks
Tuberosity: 6 weeks
Sustentaculum tali: 6 to 8 weeks
Healing time 6 to 12 weeks for complete return of function
Possible pain and stiffness for months
Follow-up visit interval Every 2 to 4 weeks
Repeat radiography interval For all fractures, after immobilization discontinued
1 week after casting of tuberosity fracture to check for alignment
Considered for delayed clinical healing
Pt instruction ROM and strengthening exercises of the foot and ankle after immobilization
Achilles tendon stretching is important to regain function
Physical therapy should be considered if more aggressive rehabilitation is needed
Heel padding as required for discomfort
Indications for Ortho consult Displaced fractures
Persistent pain
Nonunion
ROM, range of motion;
SLNWBC
, short-leg non-weight-bearing cast;
SLWC, short-leg walking cast.

 

COMPLICATIONS

Return to Work or Sports