ABSTRACT
Heel is the toughest part of the foot. ‘Heel strike’, when the foot first touches the ground, is the very first thing during the gait cycle and here most of the body weight is borne by the heel bone (calcaneus). However, at that stage the other foot is still sharing some of the weight of the body. As soon as the heel is firmly on the ground the other foot leaves the ground and then for a moment the calcaneus may-carry the whole body weight. The skin of the heel is tightly bound by numerous vertical septa extending through the subcutaneous tissue to the surface of the calcaneus. These septa result in formation of small cylinders which are packed with fat globules. During weight bearing, each fat globule changes its shape and spreads the thrust to the globules on either side as well as to those immediately below it. Thus by the time that thrust gets down to the skin it is not a small area but rather a large area that is carrying weight (Fig. 5.1). These peculiar fatty cylinders act like shock absorbers which is why, in Syme’s amputation, the heel flap is preserved for weight bearing even though the calcaneus is removed.
