Orthopedics Book

Blisters

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Calcaneus Anterior Process Fracture

Aka: Calcaneus Anterior Process Fracture
  1. Epidemiology
    1. Represents 15% of all Calcaneal Fractures
  2. Description
    1. Fracture of anterior process of Calcaneus
    2. Anterior process articulates with Cuboid and navicular
  3. 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
  4. Symptoms
    1. Provocative: Walking (but not necessarily standing)
  5. Signs
    1. Point tenderness at calcaneocuboid joint
      1. Anterior to lateral malleolus by 3 cm
  6. Differential Diagnosis
    1. Lateral Ankle Sprain
  7. 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
  8. 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
  9. Complications
    1. Fracture non-union
    2. Symptoms may persist for up to a year after Fracture
  10. References
    1. Judd (2002) Am Fam Physician 66(5): 785-94 [PubMed]

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