Calcaneal insufficiency avulsion fractures in patients with diabetes mellitus

Mary H. Kathol, Georges Y. El-Khoury, Timothy E. Moore, J. Lawrence Marsh

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Radiographs and clinical records of 61 patients with calcaneal fractures were studied. Twenty-one patients had diabetes mellitus, and 40 were nondiabetic. All diabetic patients were insulin dependent for more than 5 years and had clinically evident peripheral neuropathy. Eighteen of the diabetic patients had no history of significant trauma. Fourteen had calcaneal insufficiency avulsion (CIA) fractures limited to the posterior third of the calcaneus. The fracture pattern in this group occurred in the same plane as a fatiguetype calcaneal fracture. Fragments of the posterior tuberosity were usually displaced 10-30 mm and were frequently rotated. The mean time from diagnosis of diabetes mellitus to CIA fracture was 20 years. Fractures in the nondiabetic group and in the three diabetic patients with a history of trauma did not resemble the CIA pattern. In the nondiabetic group, there were no insufficiency fractures; 39 fractures occurred with significant force (eg, motor vehicle accident or fall from height), and 33 had extension to subtalar or calcaneocuboid joints.

Original languageEnglish (US)
Pages (from-to)725-729
Number of pages5
Issue number3
StatePublished - Sep 1991
Externally publishedYes


  • Calcaneus, fractures, 4642.415, 4642.4191, 4642.564
  • Diabetes mellitus, complications, 4642.564, 4642.821
  • Fractures, stress, 4642.415

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


Dive into the research topics of 'Calcaneal insufficiency avulsion fractures in patients with diabetes mellitus'. Together they form a unique fingerprint.

Cite this