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Neuropathic calcaneal tuberosity avulsion fractures
W C Biehl1, J M Morgan, F W Wagner
1Wagner Foot and Ankle Institute, Los Angeles, California.
Clinical Orthopaedics and Related Research
|November 1, 1993
Summary
Avulsion of the calcaneal tuberosity can signal a neuropathic fracture, especially in diabetic patients without significant trauma. Early diagnosis is crucial as it impacts treatment and prognosis.
Area of Science:
- Orthopedics
- Podiatry
- Diabetic Foot Care
Background:
- Neuropathic fractures are a significant complication in patients with peripheral neuropathy.
- Calcaneal tuberosity avulsion fractures can be an early sign of underlying neuropathic conditions.
- Diabetes mellitus is a leading cause of peripheral neuropathy, increasing fracture risk.
Observation:
- Two cases of bilateral calcaneal tuberosity avulsion fractures are presented.
- Patients presented without a clear history of significant direct or indirect trauma.
- The diagnosis was challenging due to the subtle presentation and potential for bilateral involvement.
Findings:
- Avulsion of the calcaneal tuberosity can be the initial presentation of a neuropathic fracture.
- Neuropathic fractures require investigation in patients lacking a significant trauma history.
- Consideration of neuropathic fractures is essential in patients with diabetes mellitus.
Implications:
- Accurate diagnosis of neuropathic calcaneal tuberosity avulsion fracture is critical.
- Altered diagnosis impacts the prognosis and treatment strategies for this injury.
- Increased awareness can improve patient outcomes and prevent misdiagnosis.