Presentation
Acute right foot pain after tripping down stairs.
Patient Data
Three view weight-bearing radiographs of left foot show transverse fracture through the anterior process of the calcaneus (appreciated on the lateral view).
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:
- fracture
- accessory ossicle (os calcaneus secondarius)
- fibrous calcaneonavicular coalition
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.