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The patient is an 18-year-old male who jumped or fell from a “short height” but landed hard on his heel. He is able to ambulate, but cannot put any pressure on his heel.

View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Clinical Challenge 2: July 2007

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services