Surgical excision for anterior-process fractures of the calcaneus.

Most fractures of the anterior process of the calcaneus are successfully treated with cast immobilization. Eighteen of the twenty-five patients in this study were so treated successfully, although their symptoms persisted for variable periods after removal of the cast. Seven of the twenty-five patients had excision of the fracture fragment, two of whom were not relieved of their symptoms after excision. Both of these patients had had a missed diagnosis and no prior treatment of a fracture that had gone on to non-union. This suggests that the correct initial diagnosis and treatment are important, particularly if the fracture fragment is large, and that early excision of the fragment is usually not necessary or advisable.