Excision of a Calcaneal Osteochondroma via Medial Approach: A Case Report

Osteochondromas are the most common benign bone tumours, typically arising from the metaphyses of long bones, while involvement of the calcaneus is rare. When present in the hindfoot, these lesions may become symptomatic due to mechanical irritation or proximity to Neurovascular (NV) structures, posing both diagnostic and surgical challenges. Hereby, the authors report the case of a 30-year-old male patient who presented with a one-year history of progressive medial heel pain and a palpable bony mass. Radiographs, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) demonstrated a pedunculated osteochondroma arising from the medial aspect of the calcaneus with continuity of the medullary canal and a thin cartilage cap. Due to persistent symptoms and concern for NV compression, surgical excision was performed using a medial approach. The lesion was removed en bloc with complete excision of the cartilage cap while preserving adjacent NV structures. Histopathological examination confirmed a benign osteochondroma. The patient experienced complete resolution of symptoms and returned to normal activities, with no recurrence at 12-month follow-up. The present case highlights the importance of considering calcaneal osteochondroma in patients with persistent heel pain and demonstrates that a medial surgical approach offers safe exposure, effective NV protection and favourable functional outcomes when anatomically feasible.