The largest bone in the foot is the calcaneus. Of all the fractures of the foot, fractures of the heels occur most often. Usually the cause of injury is a fall on the heels from a height, the talus (located on top) at the same time digs into the heel and splits it.
Types of Fractures
In general, fractures of the heels are diverse. They can be with displacement of fragments and without it, isolated and marginal, ordinary and fragmented (including multi-fragmented). The direction of the displacement of the fragments and the fracture line will depend on the position in which the foot was in the impact. With strong compression, a compression fracture occurs , it can occur with or without damage to the surfaces of the joints. Sometimes it happens that both heel bones break at the same time. In addition, fractures of the heels can be extra-articular and intra-articular.
Signs of a fracture
The first symptom that appears with any fracture is, of course, 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 fractures of the heels are compression, when the heel bone under the conditions of the traumatic factor is pressed against the ram and splits. In this case, when pressure is applied from the sides to the heel, severe pain will be felt, it is impossible to step on the leg, stand on the toes will also fail, while the movements in the ankle joint are preserved. When the calf muscle is stressed, the pain sensations intensify. Soft tissues swell in the sub-ankle region, hemorrhage occurs, these processes quickly spread to the Achilles tendon.
Diagnostics
Fractures of the heels are diagnosed by the results of an X-ray examination. It is not difficult to see them on radiographs. But when there is a fracture of the heel with displacement, it is difficult to correctly determine the degree of displacement of the fragments. In this case, a radiograph of a healthy foot is made and two pictures are compared.
Treatment
If a heel fracture without displacement is diagnosed, gypsum is applied to the leg to fix the bone in the desired position. They remove it when the bone is fused, that is, after about 1.5-2 months. Sometimes merging takes longer. If the bone fragments are displaced, not do without surgery. When the fracture is closed, the operation is performed after the edema subsides and inflammation decreases. In order to accelerate this, the leg is immobilized and raised for several days. Also, such measures contribute to the restoration of stretched skin. Open fractures of the heels, complicated by displacement, should be operated on immediately. During the operation, bone fragments are connected using special metal staples. After the operation, gypsum 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. In severe fractures, sometimes recovery takes several years, and sometimes even with the best efforts of doctors and the patient, it is not possible to fully restore the functions of the foot and lower leg.