A middle aged man was involved in a road traffic accident. He was driving, and was involved in a head-on collision with another vehicle, which turned in front of him. He was wearing a seat belt and, during the accident, sustained bruising to his chest and a fracture of the left calcaneum. He was taken to hospital, his left ankle was placed in a plaster of Paris backslab and he was admitted overnight for analgesia, being allowed home the following day. He was subsequently reviewed in the fracture clinic under the care of a consultant orthopaedic surgeon; the fractured calcaneum eventually healed, though with gross restriction of movement associated with a painful, stiff ankle joint, despite intensive physiotherapy. On review, it was decided that the subtalar joint should be fused.