Intra-articular Fractures

Intra-articular fractures (click on the x-ray to enlarge) are usually caused by a fall from a height onto the heel. In older patients with osteoporosis, the height may be as little as half a metre. Extra-articular fractures of the body and the medial tubercle are also caused by the same mechanism, though with lesser degrees of force. As patients usually fall onto both heels, bilateral fractures are common.

The same mechanism of injury may also cause a fracture of the lumbar spine and so all patients with calcaneal fractures must have the spine examined. If there is any suspicion of back injury (or if a back injury cannot be ruled out because of distracting pain) the lumbar and thoracic spine must be x-rayed.