Types
1. Dorsal lip fracture / Tuberosity fracture
- avulsion fractures
- most common
- beware avulsion T post
2. Body fracture
3. Stress Fractures
Body Fractures
Types
A. Transverse fracture in coronal plane
B. Transverse from dorsolateral to plantarmedial
C. Central or lateral comminution
Management
ORIF if displaced
- aim to restore TNJ
- 70% satisfactory reduction
Complications
Stiffness
- lose some inversion / eversion as part of STJ
OA
AVN 30%
4. Stress fracture
History
Pain
No distinct trauma
Xray
CT
Issue
Can go on to displaced nonunion
Management
1. Strict NWB in boot
- consider bone stimulator
2. ORIF and graft
- if >50% of width of bone and failure of non-operative management
Case 1
Case 2