- Fracture, anterior process of calcaneus
- Lateral ankle sprain
- Lateral talar process fracture
- Os calcaneus secundarius
This patient experienced a fracture of the anterior process of calcaneus.
Learnings/What to Look for
- Anterior calcaneal process fractures are the result of an inversion and plantarflexion injury. This represents an avulsion fracture of the bifurcate ligament
- Accessory ossicle (os calcaneus secundarius) can be difficult to distinguish from an anterior process fracture
- Anterior calcaneal process fractures can be missed using plain radiography. Point tenderness over the calcaneal cuboid joint may aid in diagnosis
- Undiagnosed fractures can result in nonunion
Pearls for Urgent Care Management and Considerations for Transfer
- Small, nondisplaced fractures can be managed with nonweight bearing with or without a short leg case for 4–6 weeks
- Patients can be treated on site or referred immediately for orthopedic care, with follow-up in either setting according to the provider’s expertise and available resources
- Patients with large or displaced fractures may require operative treatment and should be transferred to an emergency room
Acknowledgment: Images courtesy of Teleradiology Specialists.