Heel Fractures

The heel bone or, as it’s officially known the calcaneus, is the large bone upon which the rear part of the foot rests. It connects to two other bones known as the talus and cuboid bones. Those two bones are connected by the subtalar joint, which is important for normal foot function. The heel bone has been compared to a hard-boiled egg: a thin, hard shell on the outside with a soft, spongy bone on the inside. If the outer shell is fractured, the bone tends to collapse and break apart. This is a major injury and if the break also involves the joints, there is potential for other more long-term issues, such as chronic pain or arthritis.

Types of Calcaneus Fractures

Heel fractures are usually caused by a major traumatic incident such as a car accident or falling off a roof or ladder. A fracture of the calcaneal can occur in conjunction with other injuries, such as an ankle sprain. Less often, heel fractures are caused by repetitive stress or overuse. If a heel fracture involves the joints it is called an intra-articular fracture. It usually also involves damage to the cartilage and this is the most severe kind. Fractures that don’t involve the joint are known as extra-articular and can include avulsion fractures, which is when a piece of the bone is pulled off the heel bone by the Achilles tendon or a ligament, and also stress fractures.

Symptoms and Treatment

Signs of a calcaneal fracture may vary depending on the type of fracture but usually include: sudden and severe pain in the heel and an inability to bear weight on that foot as well as swelling and bruising of the heel and ankle. At Great Neck Family Foot Care, our board certified foot and ankle surgeons, Dr. Alec Hochstein and Dr. Diana Gagliano will conduct a thorough exam of your foot as well as get the details of how the injury to your heel occurred and any other medical conditions or diseases that you have. Digital x-rays (which can be done right in our Great Neck office) will be ordered and possibly other diagnostic tests to assess the extent of the damage to the bone and joints.

Treatment will be determined by the severity of the injury and may include:

• Immobilization by casting or other means to keep the bone in place to heal
• Keeping weight off the broken heel
• Surgery, particularly if the bones have shifted out of place