Radiology Review

Man Fell Off Roof

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A 51-year-old man is brought to your facility for evaluation of right foot pain after sustaining a fall. He was working on top of his house when he lost his balance and fell approximately 15 to 20 feet. He states he landed on his feet and has the above complaint. His medical history is significant for hypertension and heart disease. He regularly works as a truck driver and smokes one to two packs of cigarettes per day. His exam shows a middle-aged male who is uncomfortable but in no obvious distress. Primary survey is normal. His right foot shows no obvious deformity. There is some swelling and moderate tenderness over the dorsal aspect, as well as in the area of the heel. Pulses are present, sensation is intact, and good capillary refill time is noted. Portable radiograph of the right foot is obtained. What is your impression?


 

ANSWER


The radiograph shows a comminuted fracture of the os calcis, as well as a comminuted fracture of the navicular bone. CT on this patient was pending to further assess for additional fractures, and the patient will likely undergo open reduction and internal fixation for definitive treatment.

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