Calcaneal fractures are not unusual. A "lover's" fracture is a common calcaneal fracture, resulting from an axial load type of injury (falling). Radiographically, there is a decrease in Boehler's angle to less than 20 %. Moreover, 75 % of these fractures involve the subtalar joint and 10 % are bilateral. Associated fractures with the same axial load mechanism include burst fractures of the spine ("Don Juan" fracture) and pilon fractures of the distal tibia.

A	Harris radiograph. There is a comminuted fracture of the calcaneus.
B	Lateral radiograph of the ankle. This shows flattening of Boehler's angle and sclerosis through the calcaneus.
C	Axial CT. This image of both feet shows a calcaneal fracture. The normal size is included for comparison.
D	Axial CT. This image better demonstrates the comminuted calcaneal fracture.
E	Lateral radiograph of the ankle. There is a hatchet injury to the calcaneus.
F	Axial CT. This image demonstrates bilateral calcaneal fractures, due to a fall.

Links to online textbooks

• Wheeless' Orthopedics: discussion of calcaneal fractures

References:

• Wechsler RJ, Schweitzer ME, Karasick D, Deely DM, Morrison W: Helical CT of calcaneal fractures: technique and imaging features Skeletal Radiol. 1998 Jan;27(1):1-6.           [See related articles]
• Janzen DL, Connell DG, Munk PL, Buckley RE, Meek RN, Schechter MT: Intraarticular fractures of the calcaneus: value of CT findings in determining prognosis AJR Am J Roentgenol. 1992 Jun;158(6):1271-4.           [See related articles]
• Hall FM: Calcaneal avulsion fractures AJR Am J Roentgenol. 1999 Sep;173(3):854-5.           [See related articles]

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