Anterior process calcaneus fracture

Case contributed by Brian Gilcrease-Garcia
Diagnosis almost certain

Presentation

Acute right foot pain after tripping down stairs.

Patient Data

Age: 55 years
Gender: Female

Three view weight-bearing radiographs of left foot show transverse fracture through the anterior process of the calcaneus (appreciated on the lateral view).

Annotated image

Yellow arrows delineate the calcaneal fracture line. Note the sharp fracture margins, angulated corners of the fracture fragment/donor site, and nonuniform gap (wider anteriorly vs posteriorly). There is subtle posterior displacement of the fragment relative to donor site.

Case Discussion

Osseous discontinuity along the anterior process of calcaneus could represent:

In this case, the sharp margins, irregular gap,and subtle posterior fragment displacement are most consistent with an acute fracture in the setting of inciting trauma.

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