A Scoping Review: How should fractures of the Anterior Process of the Calcaneus be managed in athletes?

Lay SummaryThe Anterior Process of the Calcaneus is part of the "heel bone" (calcaneus), located near to where this bone meets the Navicular bone. Both bones are in the foot. The main mechanism that causes this injury, in the sporting context, is an avulsion injury. Essentially, a ligament, that attaches the calcaneus to the navicular, is pulled with such force that it pulls off some of the attached calcaneus bone. Commonly this occurs when athletes "roll" their ankles. Historically, these fractures have often been misdiagnosed, with fractures being mistaken for bad "sprains" and soft tissue damage. This misdiagnosis has led to the mismanagement of these injuries with poor patient outcomes and recovery. Despite growing amounts of guidance available, there is still a lack of clarity in the literature. This is particularly the case in how this injury should be managed in the athlete looking to return to sport. This review seeks to analyse the preexisting guidance in the management of these injuries, pulling resources together, to better direct the clinician and improve patient/athlete outcomes. This review will also highlight areas where more research is needed.