![]() Post-surgical dressings and a splint are applied. The wires are then removed, and a plate and screws are placed. The fragments are then placed into position.Īll fragments are temporarily held in position with small removable wires. The general alignment of the heel is restored. The sural nerve and the peroneal tendons are moved out of the way and the skin is held back by placing wires in key positions. For the standard open approach, a hockey stick or “L” incision is made on the outside of the heel. Surgery can be a same-day procedure or planned with a hospital stay.Ī tourniquet is used to minimize bleeding and to ensure proper visualization of critical structures that are protected during the surgery. The addition of a regional block can provide 12 to 24 hours of pain control after surgery. General anesthesia, used to put a patient to sleep during surgery, commonly is used along with a regional nerve block, which involves a local injection to help with pain control. 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. Screws are then placed through the skin to hold the position. The broken fragments can be realigned with the help of X-rays. Multiple small incisions are placed in critical areas around the heel. The technique of “closed” reduction and percutaneous fixation can sometimes be utilized. The fracture fragments are restored to the best possible position and a plate and screws hold the fragments in place. ![]() The incision is likened to a hockey stick or large “L” where the overlying nerve and tendons are moved out of the way. A classic “open” procedure involves an incision over the lateral aspect of the heel. 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. Smoking is considered harmful for wound and fracture healing and smokers should quit before any planned calcaneus surgery. Medications such as immuno-suppressants or steroids may slow healing and delay or preclude surgery. Surgery can safely proceed when the skin at the surgical site at the lateral heel wrinkles, indicating the dangerous swelling has gone away. It may be severe enough to delay surgery for weeks or preclude it altogether. Heel surgery often is delayed due to the swelling that typically accompanies these injuries. Elderly individuals may have difficulty with surgical rehabilitation. Patients with poor blood flow may also have difficulty healing properly. Patients with diabetes may be at increased risk for infection or wound healing problems. If the shape of the calcaneus is generally maintained, surgery may not be needed. Your surgeon may require both X-rays and a CT scan to determine if surgery is your best option. The specific type, pattern and classification of the fracture is best made by obtaining a CT scan. Identification of the fracture typically is made after a physical examination by obtaining standard foot and ankle X-rays. Surgery is recommended when a broken heel bone has lost its alignment and contour. Restoration of normal alignment and contour is considered the best way to restore function and minimize pain. ![]() The goal of heel fracture surgery is to restore the shape of the heel bone as close to normal as possible. Treatment of these fractures may require surgery. Fractures or breaks of the calcaneus commonly occur after a fall from a height or car accident. ![]()
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