How Do Calcaneal Fractures Occur?
Most calcaneal fractures are the result of a traumatic event—most commonly, falling from a height, such as a ladder, or being in an automobile accident where the heel is crushed against the floorboard. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. A smaller number of calcaneal fractures are stress fractures, caused by overuse or repetitive stress on the heel bone.
Types of Calcaneal Fractures
Fractures of the calcaneus may or may not involve the subtalar and surrounding joints. Fractures involving the joints (intra-articular fractures) are the most severe calcaneal fractures and include damage to the cartilage (the connective tissue between two bones). The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.?
Fractures that do not involve the joint (extra-articular fractures) include:
- Those caused by trauma, such as avulsion fractures (in which a piece of bone is pulled off of the calcaneus by the Achilles tendon or a ligament) or crush injuries resulting in multiple fracture fragments
- Stress fractures caused by overuse or mild injury
The severity and treatment of extra-articular fractures depend on their location and size.