What is it: A fracture of the anterior process of the calcaneus is a fracture of an extra-articular portion of the calcaneous. It can be fractured by compression of that area or by avulsion from the bifurcate ligament with foot adduction and plantarflexion.
How does it present: Patient will often have had a twisting injury to the foot and complain of pain and swelling distal to the lateral malleolus.
Common exam findings: The patient may have tenderness or swelling over the region of the anterior process of the calcaneous, a few centimeters anterior and inferior to the lateral malleolus.
Tests and treatment: The fracture should be visualized by a foot x-ray, best on the lateral view. A specific lateral oblique view of the calcaneous can be ordered for most optimal visualization. Large or displaced fractures should be referred to orthopedics, otherwise fractures may be treated with immobilization by splint and short leg casting for about four weeks.