Avulsion Fracture of the Anterior Calcaneal Process

In brief: Avulsion fractures of the anterior cal-caneal process involving the extensor digitorum brevis do not occur often. However, it is important to consider this entity in athletes who have sustained ankle injuries. This injury can easily be overlooked and misdiagnosed as a sprained ankle. While the cause of this injury (supination/inversion forces) and its symptoms are essentially the same as those of a sprained ankle, maximal tenderness is usually confined to the area below the anterior talofibular ligament. Conservative treatment is recommended in most cases; however, surgical intervention occasionally may be necessary to treat large avulsed fragments or malunions.