Fractured Heel

Facts about a Fractured Heel


It may be difficult to believe that the hardworking feet can be overused, but overuse is a common cause for a fractured heel, also known as a calcaneal stress fracture.  While there are other causes for the injury, the end result is always the same:  pain during any type of foot use.


About the foot


Feet may very well be the most misunderstood feature on the human body.  Though we depend on them to stand, walk, run, kick and more, they are rarely cared for in the manner that they should to maintain their good health.  The continual stress that is placed on the feet as we go throughout our daily routine often goes unrewarded until something goes wrong.


A complex appendage, the foot is responsible for not only holding the body stable while standing but also to propel the body as we walk and run.  It is also a human form of a shock absorber to protect our skeletal system from the jarring effects of these activities.  Numerous bones, joints, muscles, tendons, nerves and blood vessels make the work of the foot possible.  There are 3 main parts to the foot; the forefoot (which consists of the toes), the midfoot (the top of the foot and the arch below) and the hindfoot, which contains the largest of all bones in the foot, the heel.  Though a layer of fat cushions the heel bone, this is still the area that experiences the most frequent injuries.


Effects of a fractured heel


Excessive foot usage that is experienced by those who march or run on concrete surfaces are the most reported incidences of fractured heel.  However, the injury can also occur as the result of a fall, a car accident or a weakened bone disease such as osteoporosis.  Wearing ill-fitting shoes is a lesser known cause that affects the feet.  Despite how it is caused, incurring this type of injury will have an impact on the entire body.


The pain caused by the fracture on a heel can build gradually, beginning as an occasional discomfort to a piercing pain that radiates up the calf.  As physical activity continues, the pain becomes worse.  Resting the foot brings temporary relief.  There may also be bruising around the heel area, swelling up to the ankle and tenderness by touch.  Detecting the fracture is tricky; traditional x-ray examinations rarely reveal the injury.  A bone scan is able to detect the fracture in the early stages as it is a much more accurate exam.


Treatment


Heel fractures, given the appropriate time and care, often heal on their own.  The foot should be allowed to rest as much as possible.  In some cases, heel support will be recommended to hold the heel in the proper position as it heals.  The use of crutches will likely be advised to take as much of the weight, and thereby the stress, off from the fractured heel that could cause additional damage.  Complete healing will take up to 8 weeks.

 


More serious fractures may require more extensive treatment.  A plaster cast may be applied to immobilize the heel and foot during healing.  Surgery is reserved for the most serious fractures, including bones that have shifted or displaced.  Any open fracture requires surgery immediately to prevent infection.  If the skin is not broken, surgery may be postponed until the swelling has subsided.  The procedure used will depend on the type of fracture and the surgeon.  Open reduction is used when bones must be repositioned into their natural alignment; they are then secured with screws, sometimes including plates.  Percutaneous screw fixation is a less invasive form of surgery, and used when larger bones are affected that can be repositioned without the need of a large incision.  Smaller incisions will be made in order to place screws for securing the bones in place.  In cases when surgery is required to repair the damage, rehabilitation can take up to two years.


With the large amount of responsibility placed on our feet, it is little wonder that a fractured heel is one of the most common tarsal injuries.  When a fracture occurs, providing the proper time and care for healing will get most people back on their feet in no time.