What are the sequelae of a heel fracture? How to treat it?

Fracture is a common symptom. Most people suffer from fractures due to accidental injuries. Heel fractures can cause people to be unable to walk normally. So, what are the sequelae of heel fractures?

Heel fracture sequelae

If the fracture is more severely deformed, improper treatment will lead to loss of the arch of the foot, causing changes in the force line of the foot and long-term pain. Some of these patients need surgical treatment. (Comminuted fracture with a tarsal joint angle of less than 20 degrees and severe displacement)

For fractures without obvious displacement, pain may occur with changes in weather and cold after the fracture heals; this is a common sequelae of trauma.

Treatment:

1. Non-surgical treatment

(1) For non-displaced calcaneal fractures, including those with fracture lines extending to the joints, a calf plaster cast is used for 4 to 6 weeks. After clinical healing, the plaster is removed and an elastic bandage is used to promote swelling reduction. Functional exercises are performed at the same time. However, walking should not be allowed too early. Generally, walking should be allowed after 12 weeks after injury.

(2) Displaced fractures such as longitudinal calcaneal fissure, calcaneal tuberosity avulsion fracture and calcaneal talar process fracture can be treated by manual reduction under anesthesia, and then fixed in a functional position with a calf plaster for 4 to 6 weeks. Posterior tuberosity fractures need to be fixed in the plantar flexion position.

(3) Functional therapy is used for severe compression comminuted fractures in elderly people over 60 years old. That is, after resting for 3 to 5 days, the local area is bandaged with an elastic bandage, and then functional exercises are performed, supplemented by physical therapy massage, etc.

2.Surgery

(1) For lingual fractures of the calcaneus or transverse fractures of the calcaneal body that involve the joint and are displaced, they can be pried and reduced with a bone pin under anesthesia, and then fixed with a calf plaster in a slightly flexed position for 4 to 6 weeks.

(2) Displaced transverse calcaneal fractures, tongue fractures, and posterior tuberosity fractures of the calcaneus should be treated with open reduction and compression screw fixation. Postoperatively, the bone should be fixed in a functional position with plaster for 4 to 6 weeks.

(3) For young people with calcaneal compression fractures or even comminuted fractures, some people advocate early incision, reduction and bone grafting to restore the general shape of the calcaneus and the longitudinal arch of the foot. Depending on the situation, internal fixation may or may not be used, and the lower leg plaster should be used for 6 to 8 weeks after the operation.

(4) For severe comminuted fractures of the calcaneus, some people advocate early joint fusion, including the talocalcaneal and calcaneocubital joints. However, most people advocate functional therapy first to promote the disappearance of edema and prevent tendon and joint adhesion. When complications occur at a later stage, three joint fusions can be performed.

(5) Surgical methods: ① Bone pin prying reduction and fixation; ② Open reduction and compression screw fixation; ③ Open reduction and bone transplantation; ④ Joint fusion; ⑤ Calcaneus osteotomy.