- How to know if there was a fracture of the calcaneus
- How is the treatment for calcaneus fracture
- When surgery is needed
- Possible complications and sequelae
- When to start physiotherapy
- When you get back to work
The heel fracture is severe, usually leaves sequelae and has a long recovery and the person may have to stay 8 to 12 weeks without being able to support the foot on the floor. During this period, the doctor may indicate the use of a plaster initially, and after about 15 or 20 days replace it with a splint that can be removed for physiotherapy.
In the first 5 days, the person should stay as long as possible while lying down with their feet elevated so that they do not become swollen, which tends to make the pain worse. You should also not use crutches to avoid putting your foot on the floor and therefore bending your leg and moving through leaps or with the help of another person at your side can be useful for going to the bathroom, for example.
How to know if there was a fracture of the calcaneus
Symptoms that may indicate a heel fracture include pain, swelling in the foot after a foot fall. The diagnosis is made based on X-rays at two different angles and computed tomography to assess the angle of the fracture, whether small foot joints were affected and whether other foot structures such as ligaments and tendons were also affected.
How is the treatment for calcaneus fracture
The treatment is done by placing a plaster boot to immobilize the foot for a few weeks, but it may also be necessary to have surgery to consolidate the fracture, allowing the mobility of the foot.
To facilitate the movement of the person beyond the plaster boot, the doctor may recommend that you use crutches, but without ever putting your foot on the floor, and therefore the ideal is to move as little as possible, staying more seated or lying down, which can also be tiring.
Using pillows of different heights can be useful to keep the foot elevated, to deflate, support the leg and avoid pain in the buttocks or back.
When surgery is needed
Surgery after fracture of the calcaneus must be performed by the orthopedist and is usually indicated when in addition to fracture of the calcaneus, there are:
- Heel bone deviation greater than 2 millimeters; Many bone fragments that occur when the heel bone splits into many pieces; Compression of the lateral tendons due to the widening of the bone, causing tendinitis; Need to place bone graft or steel wires, plate or surgical screws for the bone to stick again; Need to perform an arthrodesis, which is the fusion between the calcaneus and the talus, which reduces the risk of osteoarthritis in the future.
The surgery does not need to be performed as soon as the fracture is identified, but it is safer to choose to have it performed between 7 and 14 days after the event so that the region is less swollen. However, it may be useful to seek the opinion of more than one orthopedist to assess the risk and the need for surgery.
The surgery takes time and even during the procedure, X-rays can be performed on the upper and lateral angle to check the positioning of the bone and plates. After surgery the doctor may recommend taking anti-inflammatories to relieve pain and inflammation and help recovery.
If wires, plates or other external fixation devices are placed, they can be removed after about 15 days, in cold blood, without anesthesia. Its removal is painful and can cause bleeding, but usually it is enough that the place is cleaned with alcohol at 70º degrees daily and the dressing can be changed whenever it is dirty or wet. In 8 days the small holes should be completely healed.
Possible complications and sequelae
After a heel fracture, complications such as osteomyelitis can occur, which is when the bone becomes infected due to the entry of viruses, fungi or bacteria causing intense local pain. Find out more here. The most common sequelae include:
- Arthrosis due to constant friction between the small joints between the bones of the foot; Pain in the heel and ankle joint; Stiffness and difficulty in moving the ankle in all directions; Enlargement of the heel, which can make it difficult to wear closed shoes; Pain on the sole of the foot, with or without a burning or tingling sensation.
It is not always possible to identify when these complications may happen, but it is possible to avoid them by following all the doctor's and physiotherapist's guidelines.
When to start physiotherapy
Physiotherapy must be individualized and the physiotherapist must evaluate each case because the treatment may not be the same for everyone. The sessions can be started as soon as possible, even before the fracture solidifies and can be several goals. In the first days after the fracture, it can be useful to do physical therapy with:
- Magnetron which is excellent for fracture healing and Nitrogen Cryotherapy like Crioflow to eliminate hematoma and deflate the foot.
In addition, techniques can be used to stretch the leg muscles, move the fingers and ankle, always respecting the pain limit and range of motion. There are several exercises that can be recommended depending on the fracture healing. Elastic bands with different intensities can be used to position the tip of the foot up, down and move the foot sideways.
When you get back to work
Usually, the person can return to work after 6 months of a heel fracture and during this period he can be on leave from work so that he can perform the necessary treatment. In some cases it may be possible to make an agreement with the employer so that the work can be carried out from home for a period, until you can return to the company, without restrictions.
