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Hindfoot Fracture (Heel/Ankle Joint)

Introduction

It takes a lot of force to fracture the bones in the hindfoot.  A fracture is a broken bone. Injuries most frequently result from car crashes or falls from a significant height.  Fractures may occur in the heel or the bone located on top of the heel.  Hindfoot fractures take a long time to heal, with or without surgery.
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Anatomy

The bones in your hindfoot include the calcaneus, known as the heel, and the talus, which is located on top of it.  The talus forms the ankle joint with the two leg bones that are positioned on its upper side.  The hindfoot bears and distributes your body weight across your foot when you stand or walk. 
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Causes

High impact forces cause hindfoot fractures.  They may result from a vehicle crash, a fall from a height, and as is becoming more common, snowboarding.
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Symptoms

Hindfoot fractures cause pain, swelling, stiffness, and bruising.  You will not be able to put weight on your foot to stand or walk.
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Diagnosis

You should contact your doctor right away if you suspect that you have fractured your hindfoot.  Prompt diagnosis and treatment can help prevent further problems.  Your doctor will review your medical history, conduct an examination, and order imaging tests.  X-rays and computed tomography (CT) scans are used to show the location of your fracture and if the broken bones have moved out of place or not.
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Treatment

In select cases, hindfoot fractures with bones that have not moved out of place may be treated without surgery.  You may wear a cast or a splint to position your foot while the bone heals.  The bone will take about six to eight weeks to heal, during which time you will not be able to put weight on your foot.  You will need to use a walker or crutches to stand or walk.
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Surgery

Surgery is necessary for most hindfoot fractures if the bones have moved out of place.  During surgery, the bones are realigned in the proper position and secured with surgical hardware.  Sometimes a bone graft is needed to fill in the gaps from crushed bone.

Following surgery, a protective cast or splint is worn while your bones heal.  You will not be able to put any weight on your foot for about 6-10 weeks.  You may need to use a cane or wear a special boot when you first begin walking.
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Recovery

Physical therapy usually follows any treatment for hindfoot fracture.  You will learn exercises to increase motion and strength in the ankle joint.  Your physical therapist will help you learn to walk with assistance, gradually increasing the amount of weight that you can put on your foot as you gain independence.  Overall, hindfoot fractures can take a long time to heal, some up to a year.  Your doctor will let you know what to expect.

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Prevention

You can help prevent future complications by receiving prompt professional care for a hindfoot fracture.  If left untreated, arthritis, deformity, and problems using the foot are likely to develop in the future.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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At The Center for Orthopaedic Surgery and Sports Medicine in San Antonio, TX, our board-certified and fellowship-trained physicians specialize in general orthopedics; total joint replacement; surgery of the hand, wrist, and elbow; arthroscopic surgery of the knee and shoulder; sports medicine; and fractures.