The avulsion fracture of the medial tubercle otherwise known as the Cedell fracture, is associated excessive forces placed on the posterior talotibial ligament via sudden pronation-dorsiflexion 1.
Fractures of the posterior talus are rare and regularly missed in plain film imaging, current literature suggest when CT is not a viable option; oblique views in external rotation can accurately examine the posteromedial tubercle 1-3.
Missed diagnosis can potentially lead to long term complications, as the fracture becomes more displaced the likelihood of the flexor hallucis longus tendon becoming stuck between the fracture fragments increases 1-3.
When diagnosed early, management of the fracture is conservative with good result 2.