History:

A female in her 20’s presents to the ER for ankle pain after falling off an e-bike.  She denies other injuries but cannot bear weight due to the pain.

Exam:

Vital signs were normal.  She has diffuse ankle and posterior foot pain

Testing:

What is the most likely diagnosis?

  • A) ankle sprain – no fracture seen
  • B) bi-malleolar fracture
  • C) calcaneus fracture
  • D) posterior talar avulsion fracture

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

<<<<<<<<<<<<<<<<<<<<< ADVERTISEMENT & SPACER >>>>>>>>>>>>>>>>>>>>>

****************************************************************************

THE EMERGENCY MEDICINE POCKETBOOK TRIFECTA

Get one of our publications, all designed specifically for Emergency Care Providers:

Emergency Medicine 1-Minute Consult, 5th edition

A-to-Z EM Pharmacopoeia & Antibiotic Guide, 4th edition

8-in-1 Emergency Department Quick Reference, 5th edition  (printable pdf only)

******************************************************************************

Check Out Our Weekly EM Case Challenges

We’re no longer emailing these but instead are posting on Facebook (ERpocketbooks.com) & Twitter (@EM1MinuteGuru) each Wednesday

***************************************************************************

<<<<<<<<<<<<<<<<<<<<<<<<< END SPACER >>>>>>>>>>>>>>>>>>>>>>>>>

ANSWERS:

What is the most likely diagnosis?

  • A) ankle sprain – no fracture seen
  • B) bi-malleolar fracture
  • C) calcaneus fracture – CORRECT: Tongue type calcaneus fracture
  • D) posterior talar avulsion fracture

 

for the Emergency Medicine 1-Minute Consult: Click HERE and scroll to appropriate page

Case Conclusion

  • This fracture is unstable and often converts to open within a few days due to the Achilles tendon pulling on the upper fragment.  Admission for surgery is prudent, which is what occurred in this case.