The largest bone in the foot is the calcaneus. Of all foot fractures, heel fractures are the most common. Usually the cause of injury is a fall on the heels from a height, while the talus (located on top) digs into the calcaneus and splits it.
Types of fractures
In general, heel fractures are varied. They can be with and without displacement of fragments, isolated and marginal, normal and fragmented (including multi-comminuted). The direction of displacement of the fragments and the fracture line will depend on the position in which the foot was during the impact. With strong compression, a compression fracture occurs, it can occur with simultaneous damage to the surfaces of the joints or without it. Sometimes it happens that both heel bones break at the same time. In addition, heel fractures can be extra-articular and intra-articular.
Signs of a fracture
The first symptom that appears with any fracture isthis, of course, is pain in the injured area. The arch of the foot is made flatter, and the heel area expands. With marginal and isolated fractures, the symptoms are not so pronounced, a person can even walk. The most severe heel fractures are compression fractures, when the calcaneus, under conditions of a traumatic factor, is pressed against the talus and splits. In this case, when pressing from the sides on the heel, severe pain will be felt, it is impossible to step on the foot, it will not work to stand on the toes either, while movements in the ankle joint remain. With tension in the calf muscle, pain intensifies. In the submalleolar region, soft tissues swell, hemorrhage occurs, these processes quickly spread to the Achilles tendon.
Diagnosis
Fractures of the heels are diagnosed by X-ray results. It is not difficult to see them on radiographs. But when there is a fracture of the heel with displacement, it can be difficult to correctly determine the degree of displacement of the fragments. In this case, an x-ray of a he althy foot is taken and the two images are compared.
Treatment
If a non-displaced heel fracture is diagnosed, a cast is applied to the leg to fix the bone in the desired position. It is removed when the bone grows together, that is, after about 1.5-2 months. Sometimes it takes longer to heal. If the bone fragments are displaced, you can not do without surgery. When the fracture is closed, the operation is performed after the swelling subsides and the inflammation decreases. Forin order to speed this up, the leg is immobilized and lifted up for several days. Also, such measures contribute to the restoration of stretched skin. Open heel fractures complicated by displacement should be operated on immediately. During the operation, using special metal staples, the bone fragments are connected. After surgery, plaster is applied. The rate of recovery depends on the type of fracture. But even with the lightest (closed and without displacement), the patient will be able to return to the previous level of activity only after 3-4 months. With severe fractures, sometimes recovery takes several years, and sometimes even with the maximum diligence of doctors and the patient, it is not possible to fully restore the functions of the foot and lower leg.
