Posteromedial tubercle fracture of the talus

Case contributed by Andrew Murphy
Diagnosis certain

Presentation

Eversion injury, unable to weight-bear.

Patient Data

Age: 30 years old
Gender: Male

Avulsion fracture of the posteromedial tubercle of the talus with minimal displacement.

Case Discussion

The avulsion fracture of the medial tubercle otherwise known as the Cedell fracture, is associated excessive forces placed on the posterior talotibial ligament via sudden pronation-dorsiflexion 1.

Fractures of the posterior talus are rare and regularly missed in plain film imaging, current literature suggest when CT is not a viable option; oblique views in external rotation can accurately examine the posteromedial tubercle 1-3.

Missed diagnosis can potentially lead to long term complications, as the fracture becomes more displaced the likelihood of the flexor hallucis longus tendon becoming stuck between the fracture fragments increases 1-3.

When diagnosed early, management of the fracture is conservative with good result 2.

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