Calcaneal fracture

Case contributed by Dr Joachim Feger

Presentation

Persistent heel pain, after a fall down stairs 4 weeks ago.

Patient Data

Age: 45 years
Gender: Female

PD mDixon and T1w images show an incomplete, non-displaced, extraarticular fracture of the calcaneal tuberosity extending to the medial surface.

Fat-saturated PD mDixon shows mild surrounding bone marrow edema and also a high signal change of the quadratus plantae muscle consistent with edema/hematoma.

Syndesmosis, talofibular, calcaneofibular and deltoid ligaments as well as peronael, long flexor and extensor tendons as well as the Achilles tendon are intact.

A follow-up x-ray of the calcaneus 14 days later shows a sclerotic line running through the posterior calcaneal tuberosity.

Case Discussion

This case demonstrates an incomplete, non-displaced, extraarticular fracture of the calcaneal tuberosity.

In this case, the patient had a single traumatic event (compression injury after fall downstairs) which caused this incomplete fracture.

There was no evidence for long-distance running or other forms of overuse in the patient history since the images would be also typical of a stress fracture.

Nondisplaced and noncomminuted calcaneal fractures may be treated conservatively with non-weight bearing for 6-8 weeks and casting or other protective footwear.

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