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Case of the Week 263

How was this injury most likely incurred?

  • You are shown 3 images in an endless loop below: one lateral of each foot and a CT of the lumbar spine

  1. Swimming pool accident
  2. Automobile collision
  3. Hunting accident
  4. Leaping from the roof
  5. Football game

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4. Leaping from the roof -- There are fractures of both calcanei and compression fractures of the lumbar spine



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Calcaneal Fracture

General Considerations

  • Calcaneous is the most commonly fractured tarsal bone
  • A so-called “lover’s Fracture” is an intra-articular fracture produced by an axial loading force typically produced by a leap from a height with person landing on heels (also called a “Don Juan” fracture)
    • Why is it called a “Lover’s fracture?”
      • Because it is the type of fracture that could presumably be caused by a lover jumping out of the bedroom window to escape from a surprised and enraged spouse
  • Bilateral in up to 10%
  • The same axial load is transmitted to the spine and may produce associated burst fractures of the lumbar or thoracic spine in up to 10% of patients
  • Frequently occur at the thoraco-lumbar junction at L1, L2, T12 and T11

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