II. Epidemiology

  1. Represents 15% of all Calcaneal Fractures

III. Description

  1. Fracture of anterior process of Calcaneus
  2. Anterior process articulates with Cuboid and navicular

IV. Types

  1. Avulsion Fracture
    1. Associated with recurrent Lateral Ankle Sprain
    2. Mechanism
      1. Ankle inversion and
      2. Plantar flexion
  2. Compression Fracture
    1. High energy injury (e.g. motor vehicle accident)
      1. Often associated with other Fractures
    2. Mechanism: Forced dorsiflexion
    3. Intra-articular Fracture

V. Symptoms

  1. Provocative: Walking (but not necessarily standing)

VI. Signs

  1. Point tenderness at calcaneocuboid joint
    1. Anterior to lateral malleolus by 3 cm

VII. Differential Diagnosis

VIII. Radiology: Foot XRay

  1. Best seen on lateral Calcaneus view
  2. Accessory ossicle at anterior process is normal variant
  3. Consider foot CT or MRI

IX. Management

  1. Nondisplaced Fracture
    1. Short Leg Cast and non-weight bearing for 4-6 weeks
  2. Large, displaced Fracture or non-union
    1. Surgery

X. Complications

  1. Fracture non-union
  2. Symptoms may persist for up to a year after Fracture

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