Calcaneal Fracture
Overview:
Subjective:
- A calcaneal fracture is a break in the heel of the foot. The calcaneus bone is responsible for transferring the ground reaction force during load acceptance. Calcaneal fractures are associated with high-energy injuries such as a falling off a ladder, automobile accident, and sports. The majority of fractures result in a closed fracture where the skin around the fracture remains intact. A fracture may occur concurrently with a sprained ankle or other fractures of the foot.
Subjective:
- Calcaneal fractures often present with an inability to walk and severe heel pain. The patient will complain of intense sudden onset of sharp heel pain during the injury. Weight bearing will reproduce the patients signs and symptoms. Swelling ad bruising will be present in the majority of calcaneal fractures.
- Foot posture, ROM, strength, neurological, functional movements and palpation tests should be performed to deferentially diagnose a fracture. The therapist should utilize the Ottawa Foot Rules to decide if the patient should have X-rays taken. Radiographic imaging is used to rule in a fracture.
Intervention:
- Metal plates and screws are used to hold the broken bone into normal alignment
-Cryotherapy
-Soft tissue techniques to the gastroc/soleus complex
-Balance exercises which may include bosu ball and wobble board exercises
-Footware advice
-Taping and bracing during sport activity
- Surgery
- Metal plates and screws are used to hold the broken bone into normal alignment
- Bracing
- Anti-Inflammatory Agents
- Modalities
-Cryotherapy
- Stretching
-Soft tissue techniques to the gastroc/soleus complex
- Therapeutic Exercise
-Balance exercises which may include bosu ball and wobble board exercises
- Patient Education
-Footware advice
-Taping and bracing during sport activity
Resources:
- http://www.med.unc.edu/emergmed/education/medical-students/files/Ottawa%20rules%20for%20x-ray%20of%20k...pdf
- http://www.westcentralohiopodiatry.com/images/stories/forms/Fractures_of_the_Calcaneus.pdf
References:
- Thomas, James, Jeffrey Christensen, Steven Kravitz, et al., "The Diagnosis and Treatment of Heel Pain" The Journal of Foot and Ankle Surgery. 40:5 (2001).
- Maskill, John, Donald Bohay, John Anderson. "Calcaneus Fractures: a Review Article" Foot and Ankle Clinics. 10; 463-489 (2005).
- http://www.physioadvisor.com.au/13134150/calcaneus-fracture-heel-fracture-physioadvisor.htm
Last Edited by: Justin Stein, SPT at AT Still University on July 12, 2014