A Rare Cause of Heel Pain: A Calcaneal Spur Fracture

Arıcan, Mehmet; Turhan, Yalçın; Karaduman, Zekeriya Okan

doi:10.7547/17-111

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…The fracture of a calcaneal spurs is extremely rare, and few cases are reported, but with recent trauma as in our case that results in fracture both heel spurs (as bilateral) are not reported up to our knowledge [ 6 , 7 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 92%

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

Aliessa¹

2022

JOCR

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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.

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Section: Discussionmentioning

confidence: 92%

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

Aliessa¹

2022

JOCR

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“…Degenerative and inflammatory diseases of the musculoskeletal system make up 70% of all benign diseases treated by irradiation [3,5,6,22,[29][30][31][32][33][34][35][36][37][38][39][40]. In Germany, more than 3500 patients annually are treated with this disease [41].…”

Section: Discussionmentioning

confidence: 99%

Low-dose radiation treatment for painful plantar enthesophyte: a highly effective therapy with little side effects

et al. 2022

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Aim Plantar enthesophyte is a common degenerative disorder. Surgical and medical treatment options are associated with either poor outcome or high percentage of relapse. Observations have indicated a beneficial effect of radiation therapy. We therefore wanted to evaluate pain reduction using orthovolt or cobalt-based radiation treatment for painful plantar enthesophyte and determine long-term response as well as prognostic parameters in this condition. Methods We identified a total of 102 consecutive patients treated for a total of 117 symptomatic heel spurs. 59 patients were treated with cobalt radiation, 31 patients with orthovolt therapy and 12 patients with both radiation systems. Primary outcome measure was pain reduction being scored using the modified Rowe Score prior therapy, at the end of each treatment series as well as after 6 weeks. Secondary outcome measure was long-term outcome, evaluated in patients with a follow-up period of longer than 3 years. Results Before radiation therapy, 61 patients (60.4%) had a score of 0, significant strong pain. At the time of completion of radiation treatment, 3 patients (2.7%) were pain-free (score of 30), whereas 8 patients (7.9%) had still severe pain (score 0). 6 weeks after radiation therapy, 33 patients (32.7%) were pain-free and 8 patients (7.9%) had severe pain (score 0), while at the time data of collection, 74 patients (73%) were free of pain and 1 patient (1%) had strong pain (score 0). Duration of pain before the start of radiation treatment was a significant prognostic factor (p = 0.012) for response to treatment. Conclusion Radiotherapy of painful plantar enthesophyte is a highly effective therapy with little side effects providing long-term therapeutic response. The only significant prognostic parameter for response to treatment is the duration of pre-radiation therapy pain. Early integration of radiation therapy in the treatment seems to result in superior pain reduction.

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“…Calcaneal spurs are commonly found associated with heel pain due to plantar fasciitis. But the fracture of a calcaneal spur is extremely rare and has only been reported sparingly as solitary case reports 1–4. Bilateral involvement has never been reported before.…”

Section: Descriptionmentioning

confidence: 99%

“…The conservative management of these fractured spurs is often sufficient to relieve pain in these cases, and surgery is rarely required 4. Various conservative treatments used for the symptomatic calcaneal spurs include non-steroidal anti-inflammatory drugs, physical modalities (like cryotherapy and ultrasonic therapy), local steroid and platelet-rich plasma injections, wearing silicone heel inserts in the shoes, extracorporeal shock wave therapy and avoiding high-impact activities 1 2. In a fractured calcaneal spur (if diagnosed early), a short leg cast may also be used.…”

Section: Descriptionmentioning

confidence: 99%