Calcaneal Fracture

One of the bones you really don't want to break.

By Marven Ewen, MD
Medical Director

I was seeing a middle-aged tradesman. He told me how he misjudged the last couple of steps of the ladder and ended up dropping onto his right foot with his knee in a fully extended position. He was wearing stiff boots and landed on a concrete floor. 

 

All the force of the fall was transmitted up through his heel bone. Even though it was a relatively short fall, he was unable to walk or even stand up due to the severe pain. He denied any other injury.

 

You might be surprised to learn that the calcaneus, or heel bone, fracture can be one of the most devastating orthopedic injuries. Although heel fractures are fairly uncommon, they can result in a very long recovery which may result in a change in occupation. It is not uncommon for a patient to take a year or more to recover from a fractured heel. 

 

Heel fractures result from a sudden and severe axial load applied to the foot, such as a fall or jump from height. I have seen a calcaneal fracture from a fall of as little as three feet, as in the case noted, but more often from a fall of greater height. The higher the fall, the more likely there will also be associated injuries, especially injuries to the lower spine and extremities.

 

Typically patients with a heel fracture will complain of severe pain and not be able to bear weight on the affected heel. When evaluating these patients, be sure to rule out associated injuries. Ensure, as in all cases of trauma, that ABCs and vitals are normal. Also check CMS to the affected foot and note swelling and tenderness around the area of the heel. 

 

Apply a bulky dressing or pillow to protect the heel on transfer. The foot should be elevated and an ice pack applied to help control pain and swelling.

 

This patient underwent a CT of his foot which both confirmed the presence of the fracture and demonstrated it was intra-articular involving the subtalar joint.  Even though he had appropriate orthopedic management, he had a very prolonged recovery and ended up retraining for a desk job as he was no longer able to be on his feet all day.

More from The Allied Times

Oh, Christmas Tree

Oh, Christmas Tree An ER visit after decorating a Christmas tree.By Marven Ewen, MDMedical DirectorIt was the Christmas holiday season. A time of good cheer, festivities and, unfortunately, holiday-related accidents.    Rudolf, a 32-year-old accountant, had just arrived home late at night from his office Christmas party, filled with Christmas cheer and spiked eggnog. He…

HIIT: A Fitness Strategy for Transformative Health

HIIT: A Fitness Strategy for Transformative Health HIIT has been a workout method for a long time – but is it actually effective?By Mariah Xzena Briones, RMTCertification SpecialistIn the fast-paced world of fitness, one approach has emerged as a game-changer—High-Intensity Interval Training (HIIT). HIIT is a fitness strategy characterized by alternating short bursts of intense…

Meet AMT: Pete J.

    Meet AMT: Pete Johnson We interview our staff members for details on their EMS journey.   When/why did you first become interested in working in the EMS field? About twelve years ago, my local Fire Department had a hiring event for paid-on call firefighting positions. At the time I saw firefighting as both…

Meet AMT: Sarah F.

Meet AMT: Sarah Fox We interview our staff members for details on their EMS journey.When/why did you first become interested in working in the medical field? I have always been interested in working in the medical field, but wasn’t sure where I belonged! In 2018, I was working in education and wanted to move to…

Auto-Brewery Syndrome

 Auto-Brewery SyndromeThe rare syndrome making yeast into alcohol – in the patient’s body.By Jenny Ewen, BA, NREMTEditor-In-ChiefThe signs of being intoxicated are typically pretty obvious – flushed cheeks, dizziness, disorientation, slurred speech, memory problems. While it usually requires actually drinking alcohol to reach this state, a rare disease actually creates these symptoms, making someone very…

Milk Wars: Cow vs Plant - Which is Healther?

Milk Wars: Cow vs. Plant – Which is Healthier? A deep dive into the nutritional profiles of many types of milks on the market.By Mariah Xzena Briones, RMTCertification SpecialistMilk has been a dietary staple for centuries, providing essential nutrients for growth and overall health; however, in recent years, the rise of plant-based milk alternatives has…

Are you ready to start saving lives?