{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:40:27Z","timestamp":1785271227218,"version":"3.55.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T00:00:00Z","timestamp":1551830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The plantar fascia attaches to the tuberosity of the calcaneus, which produces a distinct plantar medial avulsion (PMA) fracture fragment in certain calcaneal fractures. We hypothesized that tongue-type fractures, as described by the Essex-Lopresti classification, were more likely to be associated with this PMA fracture than joint depression fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review was performed at 2 distinct Level I trauma centers to identify patients sustaining calcaneal fractures. Radiographs were then reviewed to determine the Essex-Lopresti classification, OTA classification, and presence of a PMA fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The review yielded 271 total patients with 121 (44.6%) tongue-type (TT), 110 (40.6%) joint depression (JD), and 40 (14.8%) fractures not classifiable by the Essex-Lopresti classification. In the TT group, 73.6% of the patients had the PMA fracture whereas only 8.2% of JD and 15.0% of nonclassifiable fractures demonstrated a PMA fragment ( P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Plantar medial avulsion fractures occurred in 38.4% of the calcaneal fractures reviewed with a significantly greater proportion occurring in TT (73.6%) as opposed to JD (8.2%). Given the plantar fascia attachment to the PMA fragment, there may be clinical significance to identifying this fracture and changing treatment management; however, this requires further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100719830948","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T01:56:14Z","timestamp":1551923774000},"page":"634-640","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Plantar Medial Avulsion Fragment Associated With Tongue-Type Calcaneus Fractures"],"prefix":"10.1177","volume":"40","author":[{"given":"Mark R.","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Rutgers\u2013New Jersey Medical School, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth L.","family":"Koury","sequence":"additional","affiliation":[{"name":"Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaydev B.","family":"Mistry","sequence":"additional","affiliation":[{"name":"SUNY Downstate Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Braaksma","sequence":"additional","affiliation":[{"name":"Orthopaedic Associates of Port Huron, Port Huron, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Orthopedic ONE, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Firoozabadi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine, University of Washington\u2013Harborview Medical Center, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"key":"bibr1-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1177\/107110078901000206"},{"key":"bibr2-1071100719830948","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0845"},{"key":"bibr3-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2008.03.028"},{"key":"bibr4-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2005.09.016"},{"key":"bibr5-1071100719830948","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200403000-00013"},{"key":"bibr6-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18003915704"},{"key":"bibr7-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1007\/BF00435554"},{"key":"bibr8-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9290(01)00242-1"},{"key":"bibr9-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199711000-00031"},{"key":"bibr10-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800103"},{"key":"bibr11-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401501007"},{"key":"bibr12-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200711101-00001"},{"key":"bibr13-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2005.03.002"},{"key":"bibr14-1071100719830948","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0005"},{"key":"bibr15-1071100719830948","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2003.10.006"},{"key":"bibr16-1071100719830948","doi-asserted-by":"publisher","DOI":"10.55095\/achot2014\/020"},{"key":"bibr17-1071100719830948","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200002000-00009"},{"issue":"4","key":"bibr18-1071100719830948","first-page":"198","volume":"94","author":"W\u00fclker N","year":"1991","journal-title":"Unfallchirurg"}],"container-title":["Foot &amp; 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