J Korean Fract Soc.  2024 Apr;37(2):102-116. 10.12671/jkfs.2024.37.2.102.

Avulsion Fractures in the Ankle and Foot

• Lim GH
• Kim JW
• Lee SH

• KMID: 2555584
• DOI: http://doi.org/10.12671/jkfs.2024.37.2.102

Abstract

An avulsion fracture occurs when a muscle-tendon unit attached to a bone produces sufficient force to tear a fragment of the bone. If not treated properly, this injury can lead to deformity, nonunion, malunion, pain, and disability. Although avulsion fractures around the foot and ankle can occur anywhere there are tendon and ligament attachments, they are common in the anterior talofibular ligament, anterior-inferior tibiotalar ligament, calcaneal tuberosity, the base of the fifth metatarsal, and navicular bone. The optimal treatment for each fracture depends on the location and severity of the fracture. Conservative treatment involves limiting weight bearing for a period, splint immobilization, and using various orthoses. Surgical treatment is usually reserved for cases of severe displacement or when nonsurgical treatment has failed. The goals of surgery include reduction of the fracture fragment, prevention of nonunion or malunion and soft tissue injury, and early return to function. The decision for each treatment modality may depend on the patient demographics or preferences and the surgeon experience. This review summarizes previous and current views on the pathogenesis, diagnosis, and treatment of common avulsion fractures to guide the treatment and diagnosis.

Keyword

Avulsion fracture; Ankle lateral ligament; Ankle syndesmosis; Calcaneus; Metatarsal bones; Navicular bone of foot