Rearfoot Fractures - Orange County
Lateral X-ray showing longitudinal calcaneal fracture. Orange County, CA.
For Calcaneal Fractures in Orange County, if the injury involves a displaced bone, multiple breaks, or has failed to adequately heal, surgery may be required.
Rearfoot / Foot Fractures in Orange County
Our Orange County Podiatrist / Foot and Ankle Surgeon can evaluate and treat your rearfoot / foot fracture at our Irvine, CA, Huntington Beach, CA, or Orange, CA offices.
While less common than metatarsal fractures, fractures within the bones of the midfoot and rearfoot are not uncommon. Our doctor is experienced in treating all types of midfoot and rearfoot fractures. The goal of treatment is to avoid surgery if not necessary and maintain a stable and functional foot for the patient, while reducing the risk of arthritis over time.
Some of the fractures that may occur in the midfoot and rearfoot may be seen in the Navicular, Cuboid, Talar, and Calcaneal bones of the foot. Our Orange County Podiatrist / Foot and Ankle Surgeon will assist you with determining the best treatment for the type of fracture you have, based on your individual needs and goals.
Navicular Fractures in Orange County
The navicular is a bone on the inside of the midfoot. A common fracture causes the bone to break into two fragments. The surgical technique involves an incision over the fracture. The fracture is realigned to restore its anatomic position and secured with screws or a plate and screws.
Cuboid Fractures in Orange County
The cuboid is a bone on the outside of the midfoot. Typically a cuboid fracture is due to a compression injury and results in shortening of the outside of the foot. The goal of surgery is to restore the anatomy of the cuboid, and as a result restore the length of the outside of the foot. This may be done with a plate and screws directly applied to the bone or with another method.
Talus (ankle bone) Fractures in Orange County
Fractures of the talus typically divide it into two large fragments referred to as the talar head and talar body. More severe injuries can include dislocations of nearby joints. Talus fractures may be treated in a cast or surgery may be recommended.
Nonsurgical Treatment - Nonsurgical treatment is recommended for fractures in which the pieces of bones remain close together, and the joint surfaces are well aligned. Patients who smoke, have poor circulation, or other medical conditions may be treated without surgery, due to a higher risk of developing complications if surgery is performed.
Surgical Treatment - The goal of surgery is to restore the size and shape of the talus. Sometimes this is a problem as the multiple fragments of bone are like putting together the pieces of a difficult puzzle. When the bone has several large pieces, your surgeon will perform open reduction and internal fixation (ORIF). This procedure involves making a cut on the outside of your foot and placing a metal plate and/or screws to hold the bones together until healing occurs. The procedure allows for maximal recovery of the inward and outward motion of the foot.
Recovery can be prolonged. No weight or walking on the leg will be allowed for approximately 8-12 weeks. Once the bone is healed, exercise and physical therapy is started to maximize the function of the ankle. The patient should expect some swelling in the foot and ankle for several months after the procedure due to the nature of the injury.
The injury can be very debilitating with persistent pain, stiffness, and swelling, even after excellent nonsurgical or surgical treatment. However, most people, depending on the type and severity of the fracture, are able to return to most work and recreational activities.
Calcaneal Fractures in Orange County
The calcaneus, also called the heel bone, is a large bone that forms the foundation of the rear part of the foot. The calcaneus connects with the talus and cuboid bones. The connection between the talus and calcaneus forms the subtalar joint. This joint is important for normal foot function.
The calcaneus is often compared to a hard boiled egg, because it has a thin, hard shell on the outside and softer, spongy bone on the inside. When the outer shell is broken, the bone tends to collapse and become fragmented. For this reason, calcaneal fractures are severe injuries. Furthermore, if the fracture involves the joints, there is the potential for long-term consequences such as arthritis and chronic pain.
How do Calcaneal Fractures Occur?
Most calcaneal fractures in Orange County are the result of a traumatic event—most commonly, falling from a height, such as a ladder, or being in an automobile accident where the heel is crushed against the floorboard. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. A smaller number of calcaneal fractures are stress fractures, caused by overuse or repetitive stress on the heel bone.
Types of Calcaneal Fractures in Orange County
Fractures of the calcaneus may or may not involve the subtalar and surrounding joints. Fractures involving the joints (intra-articular fractures) are the most severe calcaneal fractures, and include damage to the cartilage (the connective tissue between two bones). The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.
Fractures that don’t involve the joint (extra-articular fractures) include:
Those caused by trauma, such as avulsion fractures (in which a piece of bone is pulled off of the calcaneus by the Achilles tendon or a ligament) or crush injuries resulting in multiple fracture fragments
Stress fractures, caused by overuse or mild injury.
The severity and treatment of extra-articular fractures depends on their location and size.
Signs and Symptoms of Calcaneal Fracture in Orange County
Calcaneal fractures produce different signs and symptoms, depending on whether they are traumatic or stress fractures.
The signs and symptoms of traumatic fractures may include:
Sudden pain in the heel and inability to bear weight on that foot
Swelling in the heel area
Bruising of the heel and ankle
The signs and symptoms of stress fractures may include:
Generalized pain in the heel area that usually develops slowly (over several days to weeks)
Swelling in the heel area
Diagnosis of Calcaneal Fracture in Orange County
To diagnose and evaluate a calcaneal fracture, our Orange County Podiatrist / Foot and Ankle Surgeon will ask questions about how the injury occurred, examine the affected foot and ankle, and order x-rays. In addition, advanced imaging tests are commonly required.
Treatment of Calcaneal Fracture in Orange County
Treatment of calcaneal fractures is dictated by the type of fracture and extent of the injury. The foot and ankle surgeon will discuss with the patient the best treatment—whether surgical or non-surgical—for the fracture.
For some fractures, non-surgical treatments may be used. These include:
Rest, ice, compression, and elevation (R.I.C.E.) Rest (staying off the injured foot) is needed to allow the fracture to heal. Ice reduces swelling and pain; apply a bag of ice covered with a thin towel to the affected area. Compression (wrapping the foot in an elastic bandage or wearing a compression stocking) and elevation (keeping the foot even with or slightly above the heart level) also reduce the swelling.
Immobilization. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Crutches may be needed to avoid weightbearing.
For traumatic fractures, treatment often involves surgery to reconstruct the joint, or in severe cases, to fuse the joint. The surgeon will choose the best surgical approach for the patient.
Rehabilitation for Calcaneal Fracture in Orange County
Whether the treatment for a calcaneal fracture has been surgical or non-surgical, physical therapy often plays a key role in regaining strength and restoring function.
Complications of Calcaneal Fractures in Orange County
Calcaneal fractures can be serious injuries that may produce lifelong problems. Arthritis, stiffness, and pain in the joint frequently develop. Sometimes the fractured bone fails to heal in the proper position. Other possible long-term consequences of calcaneal fractures are decreased ankle motion and walking with a limp due to collapse of the heel bone and loss of length in the leg. Patients often require additional surgery and/or long term or permanent use of a brace or an orthotic device (arch support) to help manage these complications.
Please contact our office in Irvine, Orange, or Huntington Beach in Orange County, CA to make an appointment with our foot and ankle surgeon / podiatrist (Dr. Coyer) to have your rearfoot / foot fracture in Orange County fully evaluated and treated.