Fractures of the Heel Bone

Fractures of the heel bone, or calcaneus, can be debilitating injuries.

Usually these fractures occur when tremendous forces impact the foot and damage the heel. Examples are falls from heights or motor vehicle accidents. Imagine standing on an orange and seeing it widen and squash flat. This is essentially what happens to the calcaneus.

The joint between the calcaneus and the talus is called the subtalar joint. This joint is responsible for the inward and outward movements of the foot, otherwise called inversion and eversion. When the calcaneus is fractured the movement of inversion and eversion is commonly decreased or lost completely.

The upward and downward movement of the ankle (dorsiflexion and plantarflexion) is not usually affected by fractures of the calcaneus.

There are numerous problems associated with fractures of the calcaneus. One is the widening and deformity of the bone itself.

Another is irregularity of the subtalar joint that leads to arthritis. Fractures to the calcaneus may also cause injuries to the heel cushion (the heel pad) and to the nerves and tendons surrounding the heel.

Symptoms – and Diagnostic Process
Treatment Options
Compartment Syndromes of the Foot

Compartment syndromes of the foot typically occur after fairly significant industrial, agricultural and motor vehicle accidents, in which crushing of the foot occurs, such as a car running over your foot.

The foot anatomically consists of multiple small compartments, which are filled with muscles, nerves and tendons lined by a tight membrane, or fascia.

These are anatomically distinct compartments. When injury to the foot occurs, there is commonly some bleeding that occurs in the muscles that causes swelling of the foot. What is often not understood, however, is that when swelling gets severe, the muscle starts to expand.

The lining membrane - the fascia - of each of these small compartments has a limited capacity to expand. If the muscle and fluid swelling inside the compartment become significant, they may exceed the capacity of blood flow in and out of the small compartments.

This occurrence is called a ‘compartment syndrome,’ and can be a very serious problem. If the pressure inside the compartment increases too much, the nerves and muscles start to get squeezed and stop functioning properly.

Symptoms – and Diagnostic Process
Treatment Options
Foot Fracture - Lisfranc Injury
Injuries that involve wrenching of the foot are called ‘Lisfranc’ trauma – and range from minor athletic issues, such as twisting or stepping unevenly, to the more violent injuries, that may occur in motor vehicle accidents or falls.
 
The anatomy of the tarsometatarsal joint is quite complex. It consists of the articulations of multiple bones (the five metatarsals, the three cuneiforms and the cuboid bone). Injuries to the tarsometatarsal joints are quite common.
 
Historically, this injury occurred commonly in the cavalry of the Napoleonic era. In those days, soldiers often had their feet violently wrenched in the stirrup -- and the only way it could be treated at that time was by partial amputation of the foot by Lisfranc - the renowned surgeon of Napoleon.  
 
While the term ‘Lisfranc injury’ stuck – thankfully, treatment by amputation – for these injuries -- is a thing of the past.
Symptoms – and Diagnostic Process
Treatment Options
Metatarsal Injuries

From twisting falls to dropped heavy objects, injuries to the metatarsals are sustained in many different ways. There are five metatarsals in the foot.

Each metatarsal is divided anatomically into different segments (the head and neck, the shaft, and the base). The metatarsal fracture treatment depends on where the metatarsal bone is fractured.

Symptoms – and Diagnostic Process
Treatment Options
Talus Injuries & Fractures

The talus is a critical bone of the ankle joint, and connects the leg and the foot. The talus is involved in multiple planes of movement, and joins (articulates) the ankle joint and is responsible for the upward and downward movement (dorsiflexion and plantarflexion) of the ankle.

In addition, it joins the heel bone (the calcaneus), where it is responsible for the majority of the inward and outward movement (inversion and eversion) of the foot.

Injuries of the talus may affect both the ankle and subtalar joint and affect multiple planes of movement of the foot and ankle. These injuries range from relatively minor chips or fragments that are broken off the edges of the talus to very serious fractures that can be quite devastating.

Symptoms – and Diagnostic Process
Treatment Options
Common Toe Fractures

Toe fractures are very common. Frequent injuries we see are a stepping injury of the baby toe, which occurs when the toe catches on a hard object, or fractures of the big toe occur from dropped heavy objects.

Symptoms – and Diagnostic Process
Treatment Options
Ankle Fractures

The surgeons at Coachella Valley Foot & Ankle are renowned for their expertise in correcting ankle deformities caused by unsuccessful ankle fracture treatments.

If the ankle is not repaired correctly - or does not heal well - arthritis and deformity of the ankle occurs.

Patients facing these dilemmas have turned to CVFA, where our specialists utilize innovative and proprietary techniques for salvaging very severe deformities of the ankle after previous unsuccessful fracture treatment.

The ankle joint is a unique structure that depends on perfect alignment of the bones for normal function. Although the ankle moves in an up and down direction (called dorsiflexion and plantarflexion), there is very subtle movement with twisting, called rotation. In order for the ankle to work efficiently, the bones need to line up perfectly in the socket, which is called the mortise.

Ankle fractures range from relatively minor twisting injuries to those associated with violent disruption of the ankle. There are different ‘mechanisms’ of injury that have different effects on the structure of the ankle:

-A twisting mechanism and the body rotates around the foot
-A crushing type mechanism that impacts the foot
-The twisting type of injuries are far more common, and although there is less likelihood of damage to the cartilage, the bones that make up the ankle joint must nonetheless be carefully re-aligned.

Falls from height, or motor vehicle accidents, are usually far more serious, and often associated with cartilage damage.

The ankle consists of:

-Inner aspect of the tibia (the medial malleolus)
-Outer aspect of the ankle (the fibula)
-Bone underneath the ankle (the talus)

There are many different varieties and grades of severity of ankle fractures. These may involve only the medial malleolus, only the fibula, or both bones (which is called a bi-malleolar fracture). At times the talus may completely pop out of the ankle joint associated with the fracture, which is called a fracture dislocation.

Symptoms – and Diagnostic Process
Treatment Options
Lisfranc Injury

Injuries that involve wrenching of the foot are called ‘Lisfranc’ trauma – and range from minor athletic issues, such as twisting or stepping unevenly, to the more violent injuries, that may occur in motor vehicle accidents or falls.

The anatomy of the tarsometatarsal joint is quite complex. It consists of the articulations of multiple bones (the five metatarsals, the three cuneiforms and the cuboid bone). Injuries to the tarsometatarsal joints are quite common.

Historically, this injury occurred commonly in the cavalry of the Napoleonic era. In those days, soldiers often had their feet violently wrenched in the stirrup -- and the only way it could be treated at that time was by partial amputation of the foot by Lisfranc - the renowned surgeon of Napoleon.

While the term ‘Lisfranc injury’ stuck – thankfully, treatment by amputation – for these injuries -- is a thing of the past.

Symptoms – and Diagnostic Process
Treatment Options
Compartment Syndromes of the Foot

Compartment syndromes of the foot typically occur after fairly significant industrial, agricultural and motor vehicle accidents, in which crushing of the foot occurs, such as a car running over your foot.

The foot anatomically consists of multiple small compartments, which are filled with muscles, nerves and tendons lined by a tight membrane, or fascia.

These are anatomically distinct compartments. When injury to the foot occurs, there is commonly some bleeding that occurs in the muscles that causes swelling of the foot. What is often not understood, however, is that when swelling gets severe, the muscle starts to expand.

The lining membrane - the fascia - of each of these small compartments has a limited capacity to expand. If the muscle and fluid swelling inside the compartment become significant, they may exceed the capacity of blood flow in and out of the small compartments.

This occurrence is called a ‘compartment syndrome,’ and can be a very serious problem. If the pressure inside the compartment increases too much, the nerves and muscles start to get squeezed and stop functioning properly.

Symptoms – and Diagnostic Process
Treatment Options
Stress Fractures

Stress fractures are common among athletes – and anyone else who applies unusual stress to the afflicted area.

Bones weakened by disease, such as osteoporosis, may experience stress fractures with normal use.

Stress fractures are tiny cracks in the bone as a result of injury. These cracks are caused by repetitive force applied to the bone, often by overuse. Stress fractures are most commonly found in the weight bearing bones of the lower body, including the ankle.

Symptoms – and Diagnostic Process
Treatment Options