Presence of Calcaneal Spurs and Injury Severity of Ankle Sprain in Emergency Room Patients

This study aims to evaluate the incidence of calcaneal spurs in patients presenting with ankle sprains and to determine the association between the presence of spurs and the severity of the trauma sustained. Calcaneal spurs occur in 15-20% of the general population, and when symptomatic, they can have a considerable negative impact on an individual's quality of life. We conducted a retrospective analysis of individuals aged 18 years and above who presented with ankle sprains in the emergency department over the course of 1 year. A total of 3,667 patients with ankle sprains were included in the study, with a mean age of 36.6 ± 14.2 years; 55.3% were male. Calcaneal spurs were detected in 46.3% of patients, and fractures were observed in 15.3%. Surgical intervention was required in 4.6% of the cases. The distribution of trauma severity was as follows: Grade 0 (46.6%), Grade 1 (40.4%), Grade 2 (8.4%), and Grade 3 (4.6%). A significant association was found between the presence of calcaneal spurs and increasing trauma severity grades (p < .001). Patients with calcaneal spurs had significantly higher rates of fractures, splint application, hospitalization, and surgery (p < .001). Receiver operating curve analysis showed that calcaneal spur length significantly predicted trauma severity, with an area under the curve of 0.794 (95% CI: 0.772-0.816). The optimal cut-off value was determined as 0.75 cm, yielding 82.1% sensitivity and 62.6% specificity. The presence of calcaneal spurs is significantly associated with increased trauma severity in patients with ankle sprains, highlighting the importance of early diagnosis and comprehensive management to potentially reduce severe outcomes and improve patient quality of life.