A tonguetype fracture is a type of heel fracture that is mostly caused by vertical violence. Heel fractures are the most common type of tarsal fracture, accounting for about 60% of all tarsal fractures. It is usually caused by a fall from a height, landing on the foot, and vertical impact on the heel. What are the etiologies associated with tonguetype fractures? 1. Longitudinal fracture of the heel tuberosity: Mostly caused by a fall from a height, the bottom of the tuberosity of the heel exostosis landing, and the medial elevation of the tuberosity is subjected to shear external force. It is rarely displaced and generally does not require treatment. 2. Heel nodule level (beak-shaped) fracture: a kind of Achilles tendon avulsion fracture. If the avulsion bone is small, it does not affect the function of Achilles tendon. If the fracture piece is more than 1/3 of the node, and there is rotation and serious tilt, or serious upward pull, it can be repositioned surgically and fixed with screws. 3, Achilles talonavicular fracture: it is caused by the impact of the talonavicular process inside the talus when the foot is turned inward, which is very rare. If there is displacement, the thumb can be used to push it back to the original position and fix it with a short leg cast for 4-6 weeks. 4.Fracture of the front end of the heel bone: less common. The mechanism of injury is a strong inversion of the forefoot plus plantarflexion. X-ray oblique films should be taken to exclude the fracture of the anterior superior heel process tear, and the short leg cast can be fixed for 4-6 weeks. 5.Fracture close to the heel talonavicular joint: it is a fracture of the heel body, and the mechanism of injury is also caused by a fall of the heel from a high place, or the heel is subjected to a counter-impact force from below upward. The fracture line is oblique, and in the frontal view of the X-ray, the fracture line is oblique from inside to outside, but does not pass through the heel talonavicular joint surface. Because the heel is osteophytic, the axial view shows widening of the heel body on both sides; in the lateral view, the posterior half of the heel body is displaced posteriorly along with the heel tuberosity, causing the abdomen of the heel to protrude toward the center of the foot in a rocking chair shape.