What is the actual name for the heel bone?
The heel bone is actually called the calcaneus. It’s a large bone that provides the foundation at the back of the foot, connecting the talus and cuboid bones, and forms part of the subtalar joint, which is crucial for normal foot function. It is also the attachment site for the plantar fascia and the Achilles tendon.
The calcaneus in structure is similar to a natural sponge or a crouton. It has a thin bony shell on the exterior of the bone with a trabecular or porous interior. When the calcaneus is fractured, it tends to deform and change shape more than fracture into defined hard bony fragments. Calcaneus fractures can be simple with minimal deformity or severely deformed and challenging to manage. These fractures have long-term consequences, leading to chronic pain, deformity and arthritis.
How Does Someone Fracture the Calcaneus?
Most calcaneal fractures are the result of a traumatic event, such as falling from a height or being in an automobile accident. The calcaneus is also susceptible to stress fractures caused by overuse or repetitive strain on the bone.
Types of Calcaneal Fractures
Fractures to the calcaneus can sometimes affect the subtalar and surrounding joints, but not always. In cases where the joints are involved, these fractures are referred to as “intra-articular fractures,” and they are among the most severe types of calcaneal fractures. Intra-articular fractures can also damage the cartilage. The recovery and prognosis for this type of injury depend on the severity of the calcaneus fracture.
Signs and Symptoms
Signs and symptoms of these types of injuries differ based on the mechanism of injury. Traumatic fractures typically cause sudden pain in the heel, an inability to bear weight, swelling at the ankle, and bruising of the ankle and heel. On the other hand, stress fractures also cause swelling, but the pain develops more slowly and is usually more generalized in the heel area. Pain following a stress fracture worsens as the foot is used and improves with rest.
Diagnosing a calcaneal fracture involves several steps, including a physical examination of the foot and ankle, questions about how the injury occurred, and X-rays. Additional imaging may be necessary to determine the extent of the injury such as a CT scan.
The treatment of calcaneal fractures depends on the extent of the injury and the type of fracture. Foot and ankle surgeons may recommend either surgical or non-surgical treatments, depending on the severity of the injury.
Nonsurgical Treatment Options
Non-surgical treatment options for calcaneal fractures include the R.I.C.E. technique (Rest, Ice, Compression, and Elevation), which is highly effective in treating many injuries. This method involves resting to allow the fracture to heal, icing to reduce pain and swelling, and compression and elevation to further reduce swelling. Immobilization is another common non-surgical treatment option. This can be achieved by casting or booting the foot to keep the fractured bone from moving, while crutches are used to prevent weight-bearing.
However, displaced fractures with bony deformation often require surgical intervention to reconstruct the joint and restore the alignment and shape of the bone. In severe cases, joint fusion may be necessary. The surgeon will advise on the best approach for each patient’s unique circumstances. The heel is typically immobilized for 6-12 weeks following this type of injury. Patients are allowed to move the ankle and foot as soon as possible to prevent stiffness as the injury pattern allows.
Physical therapy is an important component of surgical and non-surgical treatment for calcaneal fractures, as it helps restore function and strength.
However, these fractures are serious injuries that can result in chronic, lifelong complications. Arthritis is a common complication, and stiffness and pain in the joint are other frequent issues. If the bone heals improperly, it can lead to further complications. Additionally, calcaneal fractures can decrease hindfoot motion, causing the patient to limp. Bleeding from the fracture site can also cause scarring of the heel pad which can be treated using silicone heel pads following this injury to reduce pain. Some patients may require additional surgery to manage long-term symptoms, while others may need to use orthotic devices or braces to manage their complications.
Contact the Flint Foot & Ankle Institute Today!
If you find yourself with a fractured heel bone and are unsure about the next step, give our office a call today! Call us at 208-957-5029 or you can request an appointment here!