Calcaneous Fracture-Anterior Process 825.0

 
ICD-9 Classification / Treatment
Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References

synonyms:

Anterior Process Calcaneous ICD-9

  • 825.0(closed), 825.1(open)

Anterior Process Calcaneous Etiology / Epidemiology / Natural History

Anterior Process Calcaneous Anatomy

Anterior Process Calcaneous Clinical Evaluation

  • Tenderness in an area approximately 2 cm anterior and 1 cm inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture
  • Swelling and ecchymosis anterior and inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture.

Anterior Process Calcaneous Xray / Diagnositc Tests

  • Difficult to visualize on standard xrays
  • Consider oblique lateral radiograph directing the beam 20° superior and posterior to the midportion of the foot to visualization of the fracture.
  • CT with 1mm cuts allows accurate assessment of hindfoot fractures and is indicated for patients with clinical suspision of a hindfoot fracture and negative xrays.

Anterior Process Calcaneous Classification / Treatment

  • Acute Non-displaced (<1cm in size or <2mm displaced or <25% of calcaneal-cuboid articulation involvement):short-leg, non-weight bearing cast for 6 weeks. Advance to wbat in removable cam-walker if asymptomatic at 6weeks. (Degan TJ, JBJS 1982;64A:519)
  • Noncomminuted, Displaced (>1cm in size or >2mm displaced): ORIF with small or mini-fragment screws or k-wires. It is rare to find an anterior process calcaneal fx large enough to warrant ORIF.
  • Comminuted, Displaced: Primary excision
  • Chronic injuries generally have poor outcomes with non-surgical management and fragment excision for small non-articular fragments or ORIF for large articular fragments should be consider.

Anterior Process Calcaneous Associated Injuries / Differential Diagnosis

  • Talar OCD
  • Ankle Instability
  • Peroneal tendonitis
  • Syndesomotic injury
  • Anterior process of calcaneous fracture
  • Lateral process of talus fracture
  • Fifth metatarsal fracture (Jones Fracture)
  • Lisfranc fracture/dislocation
  • Navicular fracture

Anterior Process Calcaneous Complications

Anterior Process Calcaneous Follow-up Care

Anterior Process Calcaneous Review References

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