Understanding your injury

The calcaneus is the heel bone. A fracture may change its height, width or alignment and can damage the subtalar joint, which helps the foot adapt to uneven ground. Assessment includes the skin, circulation and nerves, with X-rays and often CT. After a major fall or collision, the team also looks for associated injuries, including injuries elsewhere in the legs or spine.

Treatment and the procedure

Treatment is tailored to the fracture, skin, health and activity needs. Some fractures are managed without surgery using protection and rehabilitation. Selected displaced fractures may benefit from repositioning and fixation through small incisions or a larger approach. Surgery is often delayed until swelling settles, but an open wound or a fragment threatening the skin needs urgent treatment. Severe joint damage may require discussion of fusion, either initially or later.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

Fixation aims to improve heel shape, joint alignment and stability. The decision also considers the wound risks of an operation; surgery is not the best option for every fracture.
Risks include wound breakdown, infection, nerve irritation, tendon problems, poor healing, loss of correction, metalwork symptoms and further operations.
Lasting swelling, a wider heel, shoe-fitting difficulties, stiffness and subtalar arthritis can occur. Severe injuries may limit walking on uneven ground and return to heavy work or impact sport.

Rehabilitation and aftercare

Your written plan determines when the heel can take weight and when movement begins. Premature loading may displace the fracture or overload the fixation. Use walking aids correctly and protect wounds and casts. Physiotherapy progresses through permitted motion, strength, balance and gait training; supportive footwear or orthoses may be helpful. Recovery depends on both bone healing and joint or soft-tissue damage. Arrange practical support and discuss work adjustments early.

When to get urgent help

Urgent assessment is needed for skin being stretched over a heel fragment, sudden severe pain or a cold or increasingly numb foot. Report fever or wound discharge promptly.
Get urgent advice for new calf pain or swelling. Call 999 for chest pain or breathlessness.

Your consultation

Ask whether the joint is involved, why surgery or nonoperative care is recommended and what lasting limitations are possible. Consent is individual and includes the risk of future arthritis and reconstruction.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Calcaneus fractures