Calcaneus Fracture Is a Broken Heel Bone

Commonly referred to as the heel bone, the calcaneus is the bone in the heel of the foot. This bone helps support the foot and is important in normal walking motions. The joint above the calcaneus, called the subtalar joint, is responsible for allowing the foot to rotate inward and outward.

Anatomy of a foot

Calcaneus fractures are almost always the result of severe, high-energy injuries. They typically occur as a result of a fall from a height, such as from a ladder. Other causes of a calcaneus fracture include automobile crashes and sports injuries. The calcaneus can also sustain a stress fracture, which is a more chronic injury sometimes seen in athletes, such as long-distance runners.

Signs of a Calcaneus Fracture

Calcaneus fractures cause swelling and pain in the back of the foot. Common signs of a calcaneus fracture include:

Most calcaneus fractures are closed injuries, meaning the skin is intact. When the skin around the calcaneus fracture is broken, this may represent an open fracture, also called a compound fracture. An open fracture of the calcaneus is an emergency that requires urgent surgery.

Treatment of Calcaneus Fractures

Calcaneus fractures may be treated with a cast, or surgery may be recommended. If the calcaneus fracture is not out of position, noninvasive treatment will be recommended. Non-operative treatment is also recommended in patients who have poor circulation or diabetes; these patients are at especially high risk for developing complications from surgery of the foot. Patients who are smokers also have a very high risk of complications related to surgery for a calcaneus fracture. Surgery must be carefully considered in these patients, and many healthcare providers believe the risks of surgery outweigh the benefits in smokers.

Surgical treatment of calcaneus fractures usually involves making an incision over the outside of the foot and placing a metal plate and screws into the broken heel bone. Your healthcare provider will attempt to restore the normal alignment of the bone and return the cartilage surface as close to normal as possible. Occasionally, if the broken calcaneus is two large pieces of bone (as compared to many small pieces) this surgery can be done with small incisions and no plate. Your healthcare provider will recommend the appropriate treatment based on the specific characteristics of your fracture.

In the most severe calcaneus fractures, the calcaneus bone may be fused to the bone above the heel, the talus. In these situations, the chance of restoring the normal joint function of the foot is unlikely, and the fusion procedure can allow a stable foot for walking.

All patients with a calcaneus fracture must also be examined for other high-energy injuries, due to the common mechanisms (such as a fall from a height) that cause such fractures. Studies have shown a large number of patients who have a calcaneus fracture will also have fractures of the lumbar spine (10 to 15 percent). Other injuries commonly occur in patients who sustain a calcaneus fracture, including injuries to the head, neck, and other extremities.

Stress fractures of the calcaneus can be treated with noninvasive treatment. Most often patients will have to be on crutches, and may even require a brief period of cast immobilization to allow the fracture to heal. Stress fractures sometimes take 3 to 6 months before athletes are able to return to sports following this injury.

Complications of Treatment

Calcaneus fractures are generally severe injuries and can lead to longstanding problems of the foot and ankle. Early complications of calcaneus fractures are most often due to the significant swelling that can occur with these injuries. Those patients who have surgery for a calcaneus fracture can develop healing problems as a result of this swelling. As mentioned, patients with diabetes, smokers, and those with poor circulation are especially prone to developing this complication.

Late complications from a calcaneus fracture are most often due to chronic foot pain and arthritis. Arthritis of the hindfoot is common after a patient sustains a calcaneus fracture. The risk of developing arthritis as a result of the calcaneus fracture is generally related to the severity of the fracture. Patients with arthritis may develop chronic foot pain, difficulty with certain types of footwear, and pain associated with walking, running, and prolonged standing.

The recovery period of a calcaneus fracture is an important aspect in determining how well a patient will return to his or her pre-injury level of activity. Patients will be required to keep weight off of the foot for as long as three months. The other critically important aspect of treatment is controlling swelling, especially in patients who have had surgery. The best ways to control swelling include elevation, immobilization, and ice application.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Davis D, Newton EJ. Calcaneus Fractures. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from:

  2. OrthoInfo from the American Academy of Orthopaedic Surgeons. Calcaneus (Heel Bone) Fractures.

  3. OrthoInfo from the American Academy of Orthopedic Surgeons. Open Fractures.

  4. Williams CG, Coffey MJ, Shorten P, Lyions JD, Laughlin RT. Staged subtalar fusion for severe calcaneus fractures with bone loss. Open Orthop J. 2013;7:614-8. doi:10.2174/1874325001307010614

  5. Li Y, Bao RH, Jiang ZQ, Wu HY. Complications in operative fixation of calcaneal fractures. Pak J Med Sci. 2016;32(4):857-62. doi: 10.12669/pjms.324.10225

Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.