IMAGES IN EMERGENCY MEDICINE
Calcaneal avulsion fracture
Department of Emergency Medicine, University Medical Center, Fresno, California, USA
Correspondence to:
Correspondence to:
T F Platts-Mills
Department of Emergency Medicine, University Medical Center, 445 S Cedar Ave, Room 275, Fresno, CA 93702-2907, USA; tplattsmills@yahoo.com
Accepted 29 March 2006
| The first 150 words of the full text of this article appear below. |
Calcaneal avulsion fractures may occur spontaneously, most often in patients with diabetes. The fracture may be missed because of the absence of trauma and the absence of tenderness in either malleolus. Operative fixation is usually required.
A 59-year-old woman with diabetes presented to the emergency department with pain in the left ankle for 2 weeks. The patient denied falling or twisting her ankle. Five days prior she was seen in a clinic and started on antibiotics. Examination showed swelling and ecchymosis. Neither malleolus was tender. The patient walked with a limp. An ankle radiograph was obtained (fig 1
).
Figure 1 Left lateral ankle radiograph shows a calcaneal avulsion fracture with the fragment pulled cephalad by the Achilles tendon.
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A lateral ankle radiograph shows a calcaneal avulsion fracture. The patient was fitted with a rigid boot and crutches. Subsequent operative fixation was achieved with a single 6.5 cm screw.
Calcaneal avulsion fractures
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