- 2 types: Avulsion and Compression Fractures:
- Avulsion Fractures: - is the more common of the 2 fractures; - mech: adduction, plantarflexion, & tension placed on bifurcate ligament; -
bifurcate ligament: - this ligament connects the anterior process of the calcaneus to both the cuboid and
navicular bones; - inversion stress of the foot will result in stretch of this ligament or avulsion fracture of the anterior process;
- Compression Fracture: - mechanism of injury is forceful abduction of forefoot w/ compression of the calcaneocuboid joint; - anterior articular surface of calcaneus is frx, & variably sized fragment can be displaaced superiorly and posteriorly, resulting in joint incongruity;
- Exam: - pain & tenderness may be located in region of sinus tarsi - point of maximal tenderness will be 2 cm anterior and 1 cm inferior to
anterior talofibular ligament, which should help distinguish this injury from a
lateral ankle sprain;
- X-ray: - lateral x-ray of hindfoot will best demonstrate compression type of frx - lateral oblique views most frequently will show avulsion fracture; - small inconsistent ossicle, calcaneus seconndatrium, lies just adjacent to anterior process and must not be confused with fresh fracture;
- Treatment: - when diagnosed early, immobilized in short leg cast for 4 weeks; - full recovery may take 6 to 9 months; ---------------------------------------------------
Anterior process fractures of the calcaneus. Surgical excision for anterior-process fractures of the calcaneus. 
