Calcaneus Fracture — Operative (ORIF or Subtalar Fusion)

South Bend Orthopaedics · SBO Physician Team

Weight-Bearing

NWB x 8 wks in splint/cast/boot; progressive WB in boot starting wk 8-12 (25% increments every 1-2 wks per X-ray confirmation of healing); transition to shoe wks 12-14; FWB wks 16-20

Key Restrictions

Strict elevation above heart 23 hrs/day wks 0-2; ice behind knee 30 min on/off; NWB x 8 wks regardless of pain; WB only when X-rays demonstrate adequate healing; subtalar arthrodesis: mobs to TC/mid/forefoot only (not fused joint); ORIF: subtalar mobs OK; no joint mobs to fused joints; scale recommended for estimating WB percentage; orthotics in final phase

Timeline & Phases

3 phases: Phase I Protection (0-6 wks with 0-2, 2-3, 4-5 wk sub-phases), Phase II ROM/Early Strengthening (6-12 wks), Phase III Progressive Strengthening (12-20 wks); pre-op PT phase for gait/crutch/knee scooter training

Notes

Includes pre-op PT; detailed fracture classification (Type I-IV); covers both ORIF and subtalar fusion with separate ROM/mob guidelines per procedure; complications noted (arthritis, peroneal impingement, sural nerve injury); outcomes: 65% limited in vigorous/sport, 50% ambulate any surface, 40% unable to return to prior employment; stationary bike in boot at 6 wks; use scale to estimate WB %

Surgeon / Author

SBO Physician Team

Published

March 2021