Calcaneus fracture or lover's fracture results from an axial load type of injury. The Calcaneus connects to the talus, which is the largest bone in the ankle. The tendons connect the muscles to the various bones of the toes and feet, which help to stand and walk. Speedy motor vehicle accidents or falls from great height might lead to calcaneus fracture. Acute pain, centered on the outer side of the ankle just below the lower leg bone is a symptom of Calcaneus fracture. This pain may be centered on the outer side of the ankle just below the lower leg bone. Sometimes the pain may focus in the heel pad. The pain becomes acute when weight is placed on the foot. The foot becomes swollen and stiff.
Sometimes it gets very difficult for the physician to diagnose a Calcaneus fracture clinically, as there may be no obvious deformity. Radiographic examinations are essential and helpful to confirm fracture of the Calcaneus. Lateral X rays of the foot are needed to evaluate the Bohler's angle in Calcaneus fractures. X ray of the lower back is also advised to see if there is a fracture there. CT scan aids in diagnosis and treatment of Calcaneus fractures.
Extra articular Calcaneus fractures: Extra articular Calcaneus is more common in people with diabetes. Extra articular Calcaneus fractures are generally treated in a closed manner. Short leg casting and no weight bearing for about two weeks followed by a range of motion exercises are normally prescribed for non displaced extra articular Calcaneus fractures. Extra articular Calcaneus fractures are further sub divided into those involving anterior process and those of the tuberosity. In elderly patients, due to osteoporosis and weakening of bones, sudden contraction of the gastrocnemius muscle occurs. Achilles gets displaced upwards. In young patients extra articular Calcaneus fracture occurs due to significant fall.
Intra-articular Calcaneus fractures: Intra articular Calcaneus fractures are initially treated with a bulky dressing with the foot elevated to the level of the heart and wrapped to keep the bones from shifting and elevation to control edema. Ice massages and packs help reduce swelling and pain. The physician applies a splint till the swelling reduces. Other treatment options for Intra articular Calcaneus fractures are a combination of open reduction, osteotomy, and internal fixation, arthrodesis of the subtalar and calcaneocuboid joints.
Surgical option becomes necessary if the bones have shifted out of place and there occurs a displaced Calcaneus fracture. A metal plate and small screws are used to hold the bones in place. Sometimes a bone graft is done to aid in the healing of the fracture. One should remember that it should take a tremendous force to break the heel bone. Therefore, even if the fracture heals, the foot may never be the same as it was before the injury. The patient may continue to experience stiffness and should wear a heel pad, a lift or a cup and special shoes if necessary. Calcaneus fractures with broken heel can be traumatic. Although the recovery can be short, it takes more than a year to heal.
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Collection of Pages - Last revised Date: February 21, 2019