The calcaneus is the bone forming the heel. It is an important bone that provides
- a stable balancing point for the foot
- lots of area for muscle attachments (particularly the achilles tendon)
Calcaneal fractures are very common, especially in young men. They are usually due to accidents, like falls onto the feet or car accidents when the injured foot is pressed against the pedal.
Fractures may occur through the middle of the calcaneus or may involve 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, and are associated with more pain and dysfunction later on. The picture above shows an intraarticular fracture as the break extends up to the joint with the bone above (Talo-Calcaneal joint).
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 not being able to stand on the foot 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.