Calcaneus Fracture
Definition
The calcaneus is the bone forming the heel. It is an important bone that provides
- connection between the leg (through the subtalar joint just below the ankle) and the foot (through the calcaneal-talar joints)
- a stable balancing point for the foot
- lots of area for muscle attachments
- supports the weight of the body.
Calcaneal fractures are very common, especially in younger men. They are usually due to high-energy accidents, like falls onto the feet or car accidents when the injured foot is pressed against the pedal.
The calcaneus has a number of bony projections that interact with other bones to form joints or attach to tendons, for example the 'posterior tuberosity' on the calcaneus attaches to the Achilles tendon. Fractures may occur through the main body of the calcaneus or may involve these bony edges breaking off.
Calcaneal fractures are generally classified into two categories:
- Extra-articular. These fractures do not involve any of the joints.
- Intra-articular. These fractures affect one or more joints. They often require more specialised surgery than extra-articular fractures in order to reset the joint, and are associated with more pain and dysfunction later on.
The calcaneus is also vulnerable to stress fractures, or subtle breaks in the weak bone.
Like many fractures in the foot, there is a long period of non-weight-bearing or partial weight-bearing during recovery, from 4 weeks up to 3 months. This can be frustrating, but long-term ankle function depends on the alignment of calcaneus with both the leg and the foot. Allowing the bones time to heal in place is consequently essential to recovery.