Heel Bone Fractures (Calcaneus Fractures): Repair With a Plate and Screws Animation

Heel Bone Fractures (Calcaneus Fractures): Repair With a Plate and Screws Animation

This video will provide an animated demonstration of a calcaneus, or heel bone fracture, being repaired with a plate and screws. A large incision is often needed over the outside of the heel to treat these fractures. However, in this demonstration, a technique using smaller surgical incisions will be shown. An incision will be made on the outside of the right foot, just above the calcaneus bone. A threaded pin will be inserted into the back of the calcaneus. The pin will act like a joystick and allow the fractures to be moved from the outside of the foot back into their normal alignment.

An appropriate size plate will be chosen and placed into the incision and slid down along the outside of the calcaneus, just overlying the fracture. A guide and drill will be used in the oblong hole in the plate. Once the hole is drilled, it will be measured for the appropriate size screw, which will then be inserted with a screwdriver. Given the more distant hole is not reachable with the small initial incision, a guide will be used to keep the surgical incision and soft-tissue trauma as minimal as possible.

The guide will be attached to the plate through the open incision, and the remaining portion of the guide will sit just above the skin. Through the guide on the outside of the skin, the surgeon will make a very small incision in the hole that mirrors the hole in the plate under the skin. Then a drill guide for a different type of screw, called a locking screw, will be inserted. Locking screws have threads that engage with corresponding threads in the plate which help minimize movement of the hardware and help compress the fracture sites for optimal healing.

Often, locking and nonlocking screws are used in combination to achieve adequate compression and stability of the fracture site. A drill will be used to make a hole in the bone. This drill guide allows the surgeon to measure the depth while drilling. The guide will be removed, and the appropriate-sized locking screw will be placed. Once the plate is secured with this screw, the guide on the outside of the skin can be removed, as well as the pin in the heel. The remaining holes will be filled in a similar fashion.

Bone cement that will be absorbed over time in the body, will be used to help fill the voids and stabilize the fragments of the fracture, ultimately helping with healing. The incisions will be closed, and the surgery will be complete.