Pseudoaneurysm of the Posterior Tibial Artery Following a Closed Fracture of the Calcaneus: A Case Report

P seudoaneurysm of an artery in close proximity to fractured bone is a well-recognized entity, and various cases involving different sites have been reported in the literature1-5. We report the case of a patient in whom a pseudoaneurysm of the posterior tibial artery developed following a closed fracture of the calcaneus. As far as we are aware, only one such case has previously been reported6. Our patient was informed that data concerning this case would be submitted for publication. A thirty-two-year-old manual laborer sustained injuries of the spine and foot following a fall from a height. He was admitted with a Chance fracture7,8 at the L1 level with paraparesis consisting of weakness mainly in the right lower extremity as well as a right-sided intra-articular calcaneal fracture. A computerized tomographic scan showed a grade-IV fracture according to the classification system of Sanders and associates9 (Fig. 1). Fig. 1 Transverse computerized tomographic scan showing the calcaneal fracture. The spinal fracture was stabilized on an emergent basis. The calcaneal fracture was treated nonoperatively because of the severe comminution. Postoperatively, the patient had development of a deep-seated infection with methicillin-resistant staphylococcus aureus at the site of the spinal procedure; the infection was treated successfully with multiple debridements and intravenous and oral antibiotics. Approximately four weeks after the injury, a pulsatile mass was noticed on the medial aspect of the ankle, posterior to the medial malleolus. The mass corresponded with the anatomical course of the posterior …