Calcaneal Tuberosity Definition, Pain, Fracture, Treatment

The calcaneal tuberosity is an essential component of the heel that serves a vital function in the maintenance of the arch of the foot as well as in the buffering of load. Avulsion fractures of the calcaneal tuberosity are common in people of advanced age as well as in sportsmen. Around  1.3  to 2.7% of all calcaneal fractures are caused by the avulsion of the calcaneal tuberosity specifically, but this is a rare occurrence.

The elderly and those with diabetes are more likely to suffer calcaneal tuberosity fractures, which are quite infrequent. Most of the time, these injuries are avulsion fractures caused by the gastrocnemius-soleus muscle complex contracting in a circular pattern. Because the displacement of these fractures might put the skin over the posterior portion of the heel at risk, early detection and intervention of the condition are absolutely necessary. In order to treat calcaneal tuberosity fractures surgically, the displaced fragment must be reduced and fixed securely. Successful management must take this pathology into account when the patient already has tightness in the gastrocnemius-soleus complex in order to improve outcomes.

Definition:

The calcaneal tuberosity is a prominent bump with medial and lateral tubercles that protrudes posteriorly from the plantar surface. Additionally, the lateral surface of the structure has a second peroneal tubercle.

The calcaneal tuberosity extends forward from the plantar surface as a big medial process and a tiny lateral process, which are partitioned by a V-shaped notch.  The calcaneal tubercle, which serves as the posterior attachment point for the short plantar ligament of the foot's sole, is located at the anterior end of the plantar surface.

Pain:

Certain calcaneal fractures are very noticeable since they cause the patient to be unable to put weight on the heel, as well as cause swelling of the heel and bruising of the heel and ankle. Most of the time, pain is bad enough to warrant a trip to the emergency department. If the injury is induced by a stress fracture, which develops gradually over time, the symptoms may be much less specific. There is a possibility of experiencing some pain, which often worsens throughout the day and is characterized as dull and achy. Bruising might or might not be evident in this case.

The heel bone can also be broken in car accidents, however, roofers and climbers are more likely to sustain a calcaneal fracture following a fall. Calcaneal fracture occurs in males between the ages of 30 and 50 more frequently than in any other age group or gender.

Calcaneal Tuberosity Fracture & its Treatment

There are two types of treatment options for calcaneal tuberosity avulsion fractures: conservative and surgical. Surgery is usually only an option for patients with more severe soft tissue irritation and larger fracture pieces that have been significantly displaced. Early surgical intervention helps to limit the occurrence of soft tissue necrosis and re-establish the normal functioning of the triceps surae and the foot.

Simple calcaneal tuberosity avulsion fractures can frequently be treated conservatively, which involves fixing the fracture in a non-weight-bearing position for 3–4 weeks with a plaster splint in the equinus position, then maintaining the fracture with a plaster cast or gradually adding weight for 3–4 weeks while wearing padded shoes. The majority of patients are able to attain favorable outcomes. Inappropriate conservative treatment, however, can result in a number of side effects, including edema, ankle stiffness, plantar flexion weakness, and persistent discomfort in the Achilles tendon attachment site. These consequences can make it difficult for the patients to perform their everyday activities.