Calcaneous Fracture-Anterior Process S92.023A 825.0

synonyms:

Anterior Process Calcaneous ICD-10

• S92.021A Displaced fracture anterior process right calcaneus, initial closed
• S92.022A Displaced fracture anterior process left calcaneus, initial closed
• S92.023A Displaced fracture anterior process unspecified calcaneus, initial closed
• S92.024A Nondisplaced fracture anterior process right calcaneus, initial closed
• S92.025A Nondisplaced fracture anterior process left calcaneus, initial closed
• S92.026A Nondisplaced fracture anterior process unspecified calcaneus, initial closed
• See all Anterior Process Calcaneus fracture ICD-10 codes

A- initial encounter for closed fracture

B- initial encounter for open fracture

D- subsequent encounter for fracture with routine healing

G- subsequent encounter for fracture with delayed healing

K- subsequent encounter for fracture with nonunion

P- subsequent encounter for fracture with malunion

S- sequela

Anterior Process Calcaneous ICD-9

• 825.0(closed), 825.1(open)

Anterior Process Calcaneous Etiology / Epidemiology / Natural History

Anterior Process Calcaneous Anatomy

Anterior Process Calcaneous Clinical Evaluation

• Tenderness in an area approximately 2 cm anterior and 1 cm inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture
• Swelling and ecchymosis anterior and inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture.

Anterior Process Calcaneous Xray / Diagnositc Tests

• Difficult to visualize on standard xrays
• Consider oblique lateral radiograph directing the beam 20° superior and posterior to the midportion of the foot to visualization of the fracture.
• CT with 1mm cuts allows accurate assessment of hindfoot fractures and is indicated for patients with clinical suspision of a hindfoot fracture and negative xrays.

Anterior Process Calcaneous Classification / Treatment

• Acute Non-displaced (<1cm in size or <2mm displaced or <25% of calcaneal-cuboid articulation involvement):short-leg, non-weight bearing cast for 6 weeks. Advance to wbat in removable cam-walker if asymptomatic at 6weeks. (Degan TJ, JBJS 1982;64A:519)
• Noncomminuted, Displaced (>1cm in size or >2mm displaced): ORIF with small or mini-fragment screws or k-wires. It is rare to find an anterior process calcaneal fx large enough to warrant ORIF.
• Comminuted, Displaced: Primary excision
• Chronic injuries generally have poor outcomes with non-surgical management and fragment excision for small non-articular fragments or ORIF for large articular fragments should be consider.

Anterior Process Calcaneous Associated Injuries / Differential Diagnosis

• Talar OCD
• Ankle Instability
• Peroneal tendonitis
• Syndesomotic injury
• Anterior process of calcaneous fracture
• Lateral process of talus fracture
• Fifth metatarsal fracture (Jones Fracture)
• Lisfranc fracture/dislocation
• Navicular fracture

Anterior Process Calcaneous Complications

Anterior Process Calcaneous Follow-up Care

Anterior Process Calcaneous Review References

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