The lateral view of the ankle shows an avulsion fracture of the calcaneal tuberosity. This is a significant injury as it involves insertion of the Achilles tendon.
This patient underwent operative reduction and tendon repair.
Calcaneal tuberosity avulsion fractures:
Achilles tendon is pulled from its insertion
Patient presents with pain and swelling in the heel
Resisted plantar flexion will be weak because of the involvement of the Achlles tendon.
Because of limited overlying soft tissue on the tuberosity, a large displaced avulsion fragment may endanger the skin.
Surgical repair of the avulsion fragment is indicated in following instances: (1) tethering of skin over the heel (2) torn Achilles tendon (3) avulsion fracture involving the articular surface of the calcaneus (4) when a prominent posterior portion of the calcaneus is going to affect shoe wear.
Reference: Rockwood and Green’s Fractures in adults