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Figures

Fig. 1

Case 1: open wound on posterior heel developed when the fracture seen in Fig. 2 was not treated expediently. The displaced fragment causes pressure on the overlying skin, leading to necrosis.

Fig. 2

Case 1: radiograph showing the displaced beak fracture. This fracture pattern must be differentiated from more common patterns as a fracture that must be reduced emergently.

Fig. 3

Case 2: a larger fracture fragment in a calcaneal avulsion fracture.

Fig. 4

Skin necrosis seen in case 2.

Fig. 5

Skin necrosis seen in case 3, which was not fixed until 2 days after the injury. At this time, it was too late, and the skin necrosed after the incision. This illustrates the importance of reducing the fragment as soon as it is recognized.

Calcaneal fractures represent approximately 2% of all fractures, of which 25% to 40% are classified as extra-articular in nature. Most calcaneal fractures are closed injuries that are treated nonoperatively, or if treated operatively, surgery is delayed to allow subsidence of swelling. The purpose of this article is to highlight a subset of calcaneal fractures that should be addressed urgently. Calcaneal tuberosity avulsion fractures often compromise the thin posterior skin that covers the insertion of the Achilles tendon.

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