The calcaneus, commonly known as the heel bone, is the largest bone located at the back of the foot. It functions as a foundational support, transferring much of the body’s weight from the lower limb to the ground during standing and walking. This irregularly shaped bone also aids stability and foot movements. Despite its robust nature and role in weight-bearing, the calcaneus can fracture under significant stress.
Key Indicators of a Broken Heel
A broken heel presents with clear signs. Sudden, severe pain in the heel is the first noticeable symptom after injury. This pain makes putting any weight on the affected foot difficult or impossible. Even light touch can cause significant tenderness.
Visible changes to the foot also indicate a calcaneus fracture. Significant swelling in the heel area is common and develops rapidly after the injury. This swelling can extend beyond the heel, affecting the entire ankle and foot. Extensive bruising, appearing as blue or purple discoloration, frequently accompanies the swelling and can spread to the sole of the foot or around the ankle.
In some cases, a broken heel might lead to a noticeable deformity of the foot. The heel may appear wider or shorter than the uninjured foot. This alteration in shape occurs when bone fragments shift out of normal alignment. Individuals often experience difficulty moving their ankle or foot due to pain and structural damage. Blisters can also form around the foot and heel in fractures with severe swelling.
Typical Ways a Heel Fractures
Calcaneus fractures result from high-energy events that exert considerable force on the foot. The most common mechanism involves falling from a significant height, such as a ladder or rooftop, where an individual lands directly on their heels. This impact drives the talus bone, located above the calcaneus, directly into the heel bone, which can cause it to shatter. The calcaneus is often compared to a hard-boiled egg; its thin, hard outer shell can collapse, causing the inner spongy bone to fragment when broken.
Motor vehicle accidents frequently cause heel fractures, particularly when the foot is crushed against the floorboard during a collision. The immense force transmitted through the leg in such incidents can severely damage the calcaneus. Sports injuries, especially those involving forceful impact or repetitive stress, can lead to calcaneal fractures. While less common, a simple twist of the ankle can also result in smaller breaks or avulsion fractures where a piece of bone is pulled away.
Immediate Steps After Suspected Injury
If a broken heel is suspected, immediate action prevents further complications. Avoid putting any weight on the injured foot to prevent further displacement or damage. Using crutches, a wheelchair, or a knee scooter can help ensure the foot remains non-weight-bearing. Elevating the injured foot above heart level can help reduce swelling and discomfort.
Applying ice to the affected area, wrapped in a cloth to protect the skin, helps minimize swelling and pain. This should be done for about 20 minutes several times a day. Seek immediate medical evaluation for proper diagnosis and treatment. Healthcare providers conduct a physical examination and order X-rays to assess the injury. A computed tomography (CT) scan provides a more detailed view of fracture lines and bone displacement, especially if the fracture involves joints.