Heel fractures are the most common of all tarsal fractures and are likely to occur in middle-aged men. Since heel fracture can severely damage the heel-talar joint, cause adhesion and stiffness, as well as spur formation and heel deformity healing, which can leave pain and motor dysfunction in the affected foot, therefore, in addition to clarifying the type of fracture, the treatment should focus on functional treatment, i.e., early movement of the affected foot and gradual weight-bearing walking to achieve satisfactory functional recovery, rather than overemphasizing anatomical repositioning of the fracture block and strong fixation. The heel bone is a cancellous bone with rich blood circulation supply, and bone discontinuity is rare. However, if the fracture line enters the articular surface or is poorly repositioned, sequelae of traumatic arthritis and pain during weight bearing of the heel bone are common. It is often associated with vertebral fractures, pelvic fractures, head, thoracic and abdominal injuries, and should not be missed at the initial consultation. Achilles fracture is the most common of all tarsal fractures, accounting for about 60% of all tarsal fractures. Most of them are caused by vertical impact on the heel after falling from a high place and landing on the foot. (1) Longitudinal fractures of the heel tuberosity are most often caused by a fall from a height, landing on the bottom of the tuberosity with the heel turned outward, and shearing external forces on the medial elevation of the tuberosity. It is rarely displaced and generally does not require treatment. (2) The heel nodule level (beak-shaped) fracture is a kind of Achilles tendon avulsion fracture. If the avulsion bone is small, it does not affect the function of the Achilles tendon. If the fracture fragment exceeds 1/3 of the tuberosity, and there is rotation and severe tilt, or serious upward pulling, it can be surgically repositioned and fixed by screws. (3) Heel talonavicular fracture is caused by the impact of the talonavicular process inside the talus when the foot is turned inward, which is rare. If there is displacement, the thumb can be used to push it back to its original position and fix it with a short leg cast for 4-6 weeks. (4) Fractures of the anterior aspect of the heel are less common. The mechanism of injury is a strong pronation of the forefoot combined with plantarflexion. An oblique X-ray should be taken to rule out a fracture of the anterosuperior heel laceration, and the short leg cast should be fixed for 4-6 weeks. (5) The fracture close to the heel talonavicular joint is a fracture of the heel body, and the mechanism of injury is also caused by a fall of the heel from a height, or by a counter-impact force of the heel 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 osteochondral, the axial view shows a 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 into a rocking chair shape toward the center of the foot. Causes of disease 1, heel deformity or bone protrusion formation: is the most common sequelae, when the heel limiting site pressure increases, easy to form callus, pain, due to the metatarsal side of the cortex is not flat stimulate the metatarsal fascia, resulting in metatarsal fasciitis and pain. 2, the talocrural joint traumatic arthritis: patients often complain of pain at the tarsal sinus health search for those diagnosed feasible joint fusion fire cans network. 3, peroneal tendon entrapment syndrome: manifestation fire cans network below the outer ankle limited focal or widespread pressure and pain when moving easily misdiagnosed as traumatic arthritis of the subtalar joint triple joint fusion, and failure to relieve pain health search can be extensive excision of hyperplasia caused by entrapment of the heel part and release the tendon fire cans network, can relieve symptoms. 4, flexor tendon adhesion claw-like toe deformity: seen in flexor and flexor tendon feasible tendon cut or release. 5, Achilles tendon weakness: because of the nodal joint angle reduction Achilles nodes upward shift the Achilles tendon relative relaxation walking weakness, heel foot gait can be corrected by heel osteotomy. 6, posterior heel pad pain: heel pad structure damage fat tissue malnutrition, pain threshold decreased. 7, nerve impingement: the posterior tibial nerve or the medial and lateral branches of the gastrocnemius nerve are caused by compression. 8, foot valgus deformity: heel body fracture after its lateral bone block outward displacement resulting in valgus flat foot can be corrected by fusion of the subtalar joint, or for heel osteotomy fire cans network. 9, heel bone infection: often due to prying and repositioning or incision and repositioning can cause heel osteomyelitis in serious cases. Treatment measures The above fracture can be rectified under lumbar anesthesia, using both hands palmar interval buckle squeeze both sides of the heel bone, correct the widening of the heel body to both sides, while in the plantar flexion position, pulling down the heel tuberosity, to restore the tuberosity joint angle. After repositioning, the calf can be fixed in a cast for 4-6 weeks. For compression fractures of the heel that affect the subtalar joint, treatment opinions are divided and can be summarized in four ways. (1) Conservative therapy, also known as sports therapy without revision. The injured foot is wrapped with an elastic bandage and the affected limb is elevated. Encourage the early start of functional movement of the affected limb and rack crutches weight-bearing. Many people believe that this method is faster and more effective than the fixed therapy for functional recovery. Generally, patients can resume normal activities within six months, and about 3/4 of them can resume normal work. It is especially suitable for compression fractures of the heel bone that do not affect the talocrural joint. (2)Bone traction treatment of the heel node under continuous traction and according to the principle of early activity can reduce the disease waste. (3) Open reduction is suitable for young people with collapsed fractures of the lateral aspect of the talus below. The angle of the talar tuberosity, and the width of the heel body can be corrected first, and then the articular surface can be surgically corrected. A lateral heel incision is made, and the collapsed articular surface is pried up to its normal position and then the cavity is filled with osteophyte to maintain the reset. Postoperatively, it was fixed with a tubular cast for 8 weeks. It is believed that internal fixation without external plaster fixation at the time of surgery is more satisfactory. (4) Early joint fixation of comminuted fractures involving joints will definitely cause irreversible damage, so if the surgery is performed within 2-3 weeks after the injury, triple joint or heel and distance joint fixation will have better results than late surgery. The above methods are general principles, but the heel fractures that affect the heel-talar joint are extremely irregular and cannot be correctly classified. The treatment is not easily uniform, the rehabilitation period is long, it is difficult to make a correct evaluation of the late results, and it is impossible to identify a specific effective treatment for each type of fracture.