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Calcaneal fracture with associated spinal injury — RCPSC EM MCQ

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EasyTraumaCalcaneal fracture with associated spinal injuryRCPSC EM

A 29-year-old construction worker falls from scaffolding. He has severe heel pain and lumbar pain. Calcaneal radiographs show a comminuted fracture and he reports urinary hesitancy with saddle paraesthesia; ankle pulses are intact. What is the most likely diagnosis?

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Correct answer: E — Associated thoracolumbar burst fracture with cauda equina involvement

High-energy calcaneal fractures are associated with axial-load spinal injury. Saddle symptoms and urinary hesitancy require urgent spine imaging and neurosurgical or spine consultation.

Reference: ATLS; Canadian orthopaedic trauma principles