Calcaneus Fracture — Non-Operative

Journal of Foot and Ankle Surgery (Asia Pacific) · B. Adhya PT; H. Dhillon PT; S. Dhillon MD; M.S. Dhillon MD — PGIMER Chandigarh…

Weight-Bearing

NWB in cast/brace wks 1-4; PWB with crutches/walker wks 5-8 (guided by radiology and surgeon); FWB initiated wks 9-12; progressive WB before 8 wks not recommended to minimize late articular collapse

Key Restrictions

Cast with ankle in neutral (sometimes slight eversion); elevation wks 1-4; no sitting with limb gravity-dependent for prolonged periods; AROM exercises hourly (tibiotalar, subtalar, midtarsal, toe joints) starting hrs 24-72; toe flexion important to prevent contractures; back slab orthosis to prevent equinus contracture; special precautions for bilateral fractures (wheelchair mobility, log roll transfers, TLS brace if concurrent spinal fracture)

Timeline & Phases

3 phases: Weeks 1-4 (immobilization/pain/edema), Weeks 5-8 (progressive WB + vigorous isometrics/ROM), Weeks 9-12 (FWB + gait normalization + strengthening); includes calcaneal stress fracture sub-protocol (NWB-PWB x 6 wks then graded running; return to sport 6-8 wks)

Notes

Peer-reviewed journal article (Open Access CC BY 4.0); covers non-operative, post-operative, stress fracture, bilateral calcaneal, and bilateral calcaneal + spinal fracture protocols; pool exercises at wk 3 (non-op) and wk 3 (op); plyometrics only after complete bone healing; 65% limited in vigorous/sport activities long-term; special bilateral/spinal fracture table; 18 references; MIS approach: ROM within 3 days; extensile incision: ROM at 10-12 days

Surgeon / Author

B. Adhya PT; H. Dhillon PT; S. Dhillon MD; M.S. Dhillon MD — PGIMER Chandigarh & Flinders University

Published

2020 (Vol 7 Issue 2)