Foot Case 5 History/Physical Exam
History and Physical Exam
Dorsal avulsion fractures usually have a history of an eversion mechanism and localized tenderness to palpation over the dorsal and medial aspect of the midfoot, where there is bony avulsion from either the talonavicular capsule or the deltoid ligament.
Patients with tuberosity fractures will also often report an eversion mechanism. Tenderness will be over the tuberosity at the insertion of the posterior tibial tendon, which is just anterior to the sustantaculum tali (a shelf of bone on the medial side of ankle about 2.5 cm below the tip of the medial malleolus). Pain is worse with passive eversion or active inversion of the foot.
Body fractures, which are uncommon, occur from an axial load and present with tenderness over the dorsal and medial midfoot.