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

The Physiology of Shock

Understanding Shock The body’s response to preserve blood flow to vital organs.By Marven Ewen, MD, ABFMMedical DirectorEMT students unfamiliar with human physiology often find it difficult to remember what symptoms to expect in the case of shock. Shock is defined as: inadequate blood circulation to meet tissue demand. In order to remember what to look…

The Three Learning Styles

By Jenny Ewen, Marketing & Student ServicesThe best way to succeed at learning, understanding, and memorizing is to know your personal learning style. That way, you can cater how you spend time in-class and studying to the methods that work best for you, instead of spending time trying to study in a way that is…

Summer is Coming: A Guide to Vitamin D

By Jenny Ewen, BA, Marketing and Student ServicesVitamin D is the best part of sunshine (besides the warmth). It is essential to your body because it is necessary to absorbing calcium and phosphorous (making strong bones and teeth), boosting your immune system, staving off depression, and even protecting against certain diseases, such as cancer. An…

Case Study: The Autonomic Nervous System

By Marven Ewen, MD, Medical DirectorThe autonomic nervous system is that part of the nervous system that is responsible for homeostasis and the flight-or-fight response. Generally, the autonomic system operates without conscious input. It is triggered by our emotional response, as well as complex hormonal feedback loops. This autonomic nervous system is composed of the…

New Location

By Sean Ewen, MD, EMTProgram DirectorI am excited to announce Allied Medical Training will soon be moving to a new location! We are coming to the end of the lease at our current facility and need more space. Our new location more than doubles our current space and provides up to 5 separate classroom areas,…

Tips for a Great Interview

By Joanne Ewen, JD, EMT, DOT-IProgram ManagerAfter sending in your stellar resume and cover letter (click here for resume tips, and here for cover letter tips), an employer may decide that you should be interviewed for a job. You’ve already made your first impression on paper, so now it’s time to bring that person on…


Are you ready to start saving lives?