Calcaneus Fracture (Heel Bone)

Description

This is a break of the calcaneus (heel bone), usually from landing hard on the heel in a fall or jump from a height. Heel fractures are uncommon in children and — reassuringly — tend to behave better in kids than in adults.

How it happens (the mechanism)

A fall or jump onto the heel drives the body’s weight straight down into the calcaneus and breaks it. Because the injury comes from landing on the feet from a height, the same force can travel up the body — so part of evaluating a heel fracture is checking the other foot, the ankles, and sometimes the back, where a companion injury can hide.

What matters

Children’s heel fractures are more forgiving than adults’, because a child’s bone is more resilient and the joint surfaces remodel better — so many breaks that would be operated on in an adult heal well in a cast in a child. The key habit is screening for the companion injuries that a fall-from-height can cause.

Symptoms

A painful, swollen, bruised heel with difficulty or inability to bear weight after a fall or jump.

Doctor examination and imaging

The doctor examines the heel and checks for injuries elsewhere from the fall; X-rays show the fracture and a CT is sometimes used for breaks into the joint.

Treatment

Most are treated without surgery, with a cast or boot and a period of limited weight-bearing while the bone heals. A displaced fracture into the joint may occasionally need a procedure, less commonly than in adults.

Recovery and long-term outlook

Most pediatric heel fractures heal well, with a gradual return to weight-bearing and activity.

When to call the doctor

Call the office right away if your child’s toes become numb, pale, blue, or cold; pain keeps worsening even after raising the leg and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Calcaneus (Heel Bone) Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.