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Extensor Digitorum Brevis Avulsion

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
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History

12 year old male with post-traumatic ankle pain.


Case Images


Diagnosis

Extensor Digitorum Brevis Avulsion

Findings

CR – Long thin fragment along the lateral calcaneus.

Discussion

The extensor digitorum brevis muscle originates along the dorsolateral aspect of the posterior calcaneal body and divides into four bellies and tendons inserting onto the proximal phalanges of the first through fourth digits. Forceful inversion of the foot may result in avulsion at the origin of the muscle. Muscle contraction and hematoma cause lateral displacement of the fragment. This injury has been shown to occur in 10% of emergency room patients with clinically suspected ankle fractures but is often difficult to profile or confused with the os peroneum. The routine dorsoplantar view of the foot and/or the routine anteroposterior view of the ankle best demonstrate the fracture. Treatment is conservative with elevation, supportive bandage, and early activity.

Reference

JF Norfray, LF Rogers, GP Adamo, HC Groves and WJ Heiser. Common calcaneal avulsion fracture. AJR (1980); 134(1): 119-123.



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