Introduction
A calcaneal fracture is a fracture of the calcaneus, i.e. part of the ankle joint. Such fractures are usually caused by traffic accidents or a fall from a great height. The resulting fracture usually causes patients great pain. Depending on the type of injury, a calcaneal fracture can be treated either conservatively (i.e. without surgery) or, more frequently, surgically. At least in the case of complicated fractures, long-term consequences of this type of injury are not uncommon.
Definition
A calcaneal fracture is the fracture of the heel bone at any point. A distinction is made here between impression fractures (in which the tibia is pressed against the calcaneus and therefore leads to a fracture relatively centrally) and marginal fractures. In addition, a distinction can be made between an isolated calcaneal fracture (i.e. when there is no other damage, which always means that the joint is not involved, and is therefore referred to as an extra-articular fracture) and a calcaneal fracture in which the joint (intra-articular fracture) or other structures such as the Achilles tendon (then also known as duck’s beak fracture) are also affected.
Causes
The classic injury mechanism underlying a heel bone fracture is a fall from a great height. When landing, a large force is exerted on the heel bone, which it cannot withstand and ultimately breaks through. This results in a so-called impression fracture.
This fracture often occurs on both sides. Consequently, people who practice high-risk sports, such as parachutists or climbers, are often affected. Sometimes, on the other hand, even a false occurrence following a “normal” jump is sufficient to cause a heel bone fracture.
Depending on the course of events, some traffic accidents can also be accompanied by a fracture of the temporal bone. A twisting of the ankle joint can also lead to a fracture of the calcaneus, but in such a case the heel bone is usually fractured at the edges. More rarely, a petrous bone fracture occurs at the bottom of a pre-existing fatigue symptom of this bone, such as can occur in the context of osteoporosis. In this case, the external force does not have to be as high as usual because the damaged bone breaks more quickly.
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