Foot & Ankle Surgery: Techniques, Reports & Cases (Jan 2023)
Insufficiency fracture of the body of the calcaneus: A case study
Abstract
Insufficiency fractures of the body of the calcaneus are a rare pathology, typically seen in women with osteoporosis. Our patient was seen by multiple physicians over the course of the year with no symptomatic relief. Her previous treatments included serial heel injections, physical therapy and non-weight bearing in a short leg synthetic cast. Initial radiographs revealed no osseous pathology that correlated with the area of pain and swelling. Magnetic resonance imaging (MRI) was obtained which suggested findings for an insufficiency fracture with increased signal intensity on T2 and decreased signal intensity on T1 in the calcaneus. The patient opted for surgical management and underwent subchondroplasty and repair with microfracture of the left calcaneus. At the first post-operative appointment she had significant pain relief, and she was later able to resume her previous activities pain free. This case demonstrates the importance of maintaining insufficiency fractures as a differential diagnosis and the success of using microfracture and subchondroplasty when non-surgical measures have failed.
