A Case Report of Bilateral Calcaneal Spur Fracture after Fall from a Height

Abstract

Introduction:A calcaneal spur (also known as a heel spur) is a bony outgrowth from the calcaneal tuberosity. Calcaneal spurs are typically detected by X-ray examination. It is a form of exostosis, and it can be fractured as result of trauma as any other bone. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period but may also be associated with ankylosing spondylitis (typically in children). A posterior calcaneal spur develops on the back of the heel at the insertion of the Achilles tendon. The only abnormal physical sings are localized tenderness beneath the calcaneum, X-ray sometimes shows a bony spur projecting forward from the under surface of the calcaneal tuberosity. We report a -60-year-old male presented with painful swelling of both heels, after fall from height about 1–2 m, the patient had chronic plantar fasciitis. X-ray done, revealed bilateral calcaneal spur fracture (distal tip), associated with posterior calcaneal spur. The patient treated with well-padded posterior slab for 2–3 weeks, ice pack, analgesia, and non-weight bearing. Case Reports:A 60-year-old man had history of trauma (fall from height about 1–2 m) on his heels, he presented with painful swelling on both heels, with mild limitation of ankle movement. On examination, there were a tender, swelling, mild ecchymosis around the heels, with painful limitation of ankle motion, and pain on weight-bearing. Radiological examination was done for spine, pelvis, hips, all within normal, and ankle X-ray. A/P and lateral revealed bilateral fracture of calcaneal spur. The patient was treated with rest, elevation, ice pack ,and analgesia for 2–3 days, then applications of back slab for 2–3 weeks. By the end of 3rd weeks, the back slab was removed and continue crepe bandage and non-steroidal anti-inflammatory drugs. After 2–3 months of follow-up, the patient no longer had swelling and pain, only mild symptoms of painful heel syndrome. Conclusion:This article presents a rare case of bilateral calcaneal spur fracture in the patient with plantar fasciitis and calcaneal spur, following trauma to both heels, so an awareness of this condition as one of the differential diagnoses of painful heels following trauma. Keywords:Calcaneal spur, heel pain, fracture calcaneal spur.