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Calcaneal Fracture Fixation

What it is:

Fractures of the heel bone, or calcaneus, can be disabling injuries. They most often occur during high-energy collisions — such as a fall from height or a motor vehicle crash. Because of this, calcaneus fractures are often severe and may result in long-term problems.

The calcaneus is the most frequently fractured tarsal bone. Tarsal bone fractures account for about 2% of all adult fractures. Of these, 60% are calcaneus fractures.


The calcaneus can be injured in a fall, twisting injury, or motor vehicle collision. A simple twisting injury may result in the calcaneus being cracked. The force of a head-on car collision may result in the bone being shattered (comminuted fracture).

Different causes can result in similar fracture patterns. For example, when landing on your feet from a fall, your body’s weight is directed downward. It drives the talus bone down into the calcaneus. In a motor vehicle crash, the calcaneus is driven up against the talus. In both cases, the resulting fracture patterns are similar. The greater the impact, the more the calcaneus is damaged.

What is ORIF Surgery?

An open reduction internal fixation (ORIF) refers to a surgical procedure to fix a severe bone fracture, or break. “Open reduction” means surgery is needed to realign the bone fracture into the normal position. “Internal fixation” refers to the steel rods, screws, or plates used to keep the bone fracture stable in order to heal the right way and to help prevent infection.

The surgical procedure is performed by a doctor who specializes in orthopedics. Under general anesthesia, an incision is made at the site of the break or injury, and the fracture is carefully re-aligned or the joint replaced. The hardware is installed, and the incision is closed with staples or stitches. The steel rods, screws, or plates can be permanent, or temporary and removed when healing takes place.

Once the open reduction internal fixation is performed, a cast is usually applied. In the case of an ankle fracture, for instance, the first cast is a non-weight bearing cast, and crutches can be used to help keep weight off the healing bones. Later, when the healing has progressed, this cast will be replaced with one that can bear weight. Eventually, after a period of some weeks, the cast will be removed entirely.

Recovery Rate & Process of ORIF Surgery:

Recovery from a bone fracture after an open reduction internal fixation can be quite painful. Physical therapy is an important part of the recovery process after an open reduction internal fixation. Since the part of the body that has been injured is usually held still or immobilized for a long period of time, the muscles, tendons, and ligaments can become weak. Physical therapy helps to restore the strength, range of motion, and endurance of the affected area. It can also help with pain management.