Fractures of a calcaneal bone make about 4% of total number of changes. Practically always falling from height in a standing position owing to blow by heels about the earth result. Are often combined with fractures of lumbar and chest vertebras, changes and perelomovyvikha of anklebones. In 15% of cases bilateral fractures of calcaneal bones are observed. Symptoms of a fracture of calcaneal bone include pains and puffiness of calcaneal area, expansion and flattening of a heel, impossibility of the opera on a heel at safety of volume of movements of an ankle joint. Diagnosis of a fracture of calcaneal bone is made by the traumatologist according to a foot X-ray analysis in 3 projections. Treatment includes imposing plaster steaks from fingers to a knee, then carrying out LFK and massage.
Fracture of a calcaneal bone
Fractures of a calcaneal bone make about 4% of total number of changes. Practically always falling from height in a standing position owing to blow by heels about the earth result. Are often combined with fractures of lumbar and chest vertebras, changes and perelomovyvikha of anklebones. In 15% of cases bilateral fractures of calcaneal bones are observed.
Calcaneal bone – the largest bone of foot bearing the main part of loading when standing and walking. Allocate two main parts of a calcaneal bone: a body and the hillock located behind. From above the calcaneal bone connects to a collision bone, in front – with cubical. The collision bone performs function of a link between a calcaneal bone and bones of a shin. When falling on heels the gravity of all body is transmitted through shin bones on a collision bone which puts in a calcaneal bone and splits it into parts. The type of a fracture of calcaneal bone and the direction of shift of its otlomk depend on height of falling and the provision of foot at the time of blow about the earth.
Allocate inside - and extra articulate fractures of calcaneal bones. Extra articulate changes make 20% of total number of fractures of calcaneal bone, are subdivided into fractures of a body and a hillock of a calcaneal bone. Hillock changes, in turn, are divided in traumatology into horizontal and vertical changes, separations of a median hillock and changes as "beak". Include fractures of a calcaneal bone which line extends to the area of a subcollision joint in group of intra articulate changes. Fractures of calcaneal bones can be compression, isolated and regional, without shift and with the shift of otlomk.
The patient shows complaints to pains in a heel. At survey the heel hypostasis extending to an Achilles tendon, flattening and expansion of a heel, a hematoma in the center of a sole comes to light. The palpation of the place of damage is sharply painful, the support on a leg is impossible. The movements in an ankle joint are kept.
Fractures of calcaneal bones sometimes remain unnoticed against the background of the injuries of a backbone and anklebones which are followed by bright symptomatology. Therefore all patients with the characteristic mechanism of a trauma (falling on legs from height more than 1,5 m) and the listed above injuries have to be examined for an exception of fractures of calcaneal bones. For confirmation of the diagnosis and specification of degree of shift of fragments carry out a X-ray analysis in three projections. About expressiveness of pathological changes judge by change of a corner of Beler (a corner of a hillock of a calcaneal bone).
treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!
Fractures of a calcaneal bone without shift are treated by the traumatologist conservatively. The immobilization plaster longety from a knee to foot fingers for a period of 3-8 weeks is carried out. Regardless of absence or presence of shift of fragments at receipt the patient is strictly forbidden to be pushed around as early loading can cause the secondary shift of otlomk. In the subsequent appoint LFK, physiotreatment, massage. To the patient recommend to wear orthopedic shoes with instep supports, at least, within 6 months.
At a fracture of a calcaneal bone with shift carry out a repozition under local anesthesia. Special difficulty is presented by treatment of the multisplintered compression fractures of body of a calcaneal bone which are followed by the big shift of bone fragments, damage of articulate surfaces of collision and calcaneal bones. At inefficiency of the closed repozition carry out an osteosynthesis with use of the device of Ilizarov. It is necessary to apply a nakostny and intra bone metalwork with care because of big danger of complications.
In the remote period after fractures of a calcaneal bone post-traumatic flat-footedness, deformations of foot, arthroses of a joint of Shopar and a subcollision joint often develops. Formation of the bone ledges breaking basic function of an extremity is possible.