Frx of the Anterior Calcaneal Process
- 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;
- 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;
- 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;
- when diagnosed early, immobilized in short leg cast for 4 weeks;
- full recovery may take 6 to 9 months
Anterior process fracture of the calcaneus.
Surgical excision for anterior-process fractures of the calcaneus.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Wednesday, September 5, 2012 1:04 pm