Cedell fracture


Posterior talar process fracture with injury to the posteromedial tubercle caused by forced dorsiflexion and pronation

Fracture of the posterior process of the talus is an uncommon injury that is often missed on plain X-Ray and misdiagnosed as ankle sprain. In one case series, 17 of 20 patients with fractures were misdiagnosed as an ankle sprain. [PMID 6650722]

Key to suspecting a fracture of the posteromedial tubercle is pain and oedema localized to the posteromedial aspect of the ankle, one finger breadth posteroinferior to the medial malleolus. Additionally flexor hallucis longus motion may elicit pain. [PMID 25179454]


1974 Fracture of the posteromedial tubercle of the talus first described in 4 patients by Cedell in 1974

Isolated rupture of the posterior talotibial ligament is probably a very rare injury. The author has diagnosed this ligament injury in four portsmen, who had a chronic state of insufficiency with medial pain and swelling in the ankle joint. Clinical examination revealed the occurrence of a bony and tender formation behind the medial malleolus which at operation was found to be an unhealed avulsion fragment belonging to the medial tubercle of the talus. [Cedell 1974]

2017 Watanabe further define fracture of the posteromedial tubercle (Cedell fracture) into three types according to the mechanism of injury and the fracture configuration

  1. Avulsion type
  2. Split type
  3. Comminuted type
posteromedial tubercle frqacture classification watanabe 2017

Associated Persons


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Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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