II. Types
- Medial tubercle of posterior talar process
- Mechanism: Ankle dorsiflexion with pronation
- Lateral tubercle of posterior talar process
- Mechanism: Plantar flexion or forced inversion
III. Signs: Medial tubercle Fracture
- Tenderness to palpation posterior to medial malleolus
IV. Signs: Lateral tubercle Fracture
- Tenderness anterior to achilles tendon at lateral ankle
- Provocative maneuvers: Plantar flexion
V. Radiology: Ankle XRay
- Lateral tubercle: Lateral XRay
- Note that accessory ossicle is normal variant
- Medial tubercle: Oblique Ankle XRay
- Hold foot in 40 degrees external rotation
VI. Management
- Non-weight bearing Short Leg Cast for 4 to 6 weeks
- Indicated for small, non-displaced Fractures
- Surgical repair
- Large or displaced Fractures