II. Types

  1. Medial tubercle of posterior talar process
    1. Mechanism: Ankle dorsiflexion with pronation
  2. Lateral tubercle of posterior talar process
    1. Mechanism: Plantar flexion or forced inversion

III. Signs: Medial tubercle Fracture

  1. Tenderness to palpation posterior to medial malleolus

IV. Signs: Lateral tubercle Fracture

  1. Tenderness anterior to achilles tendon at lateral ankle
  2. Provocative maneuvers: Plantar flexion

V. Radiology: Ankle XRay

  1. Lateral tubercle: Lateral XRay
    1. Note that accessory ossicle is normal variant
  2. Medial tubercle: Oblique Ankle XRay
    1. Hold foot in 40 degrees external rotation

VI. Management

  1. Non-weight bearing Short Leg Cast for 4 to 6 weeks
    1. Indicated for small, non-displaced Fractures
  2. Surgical repair
    1. Large or displaced Fractures

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