Which of the following tarsal bones is most commonly fractured?

Appeared in: AIIMS Jodhpur SNO-2023

Explanation

The calcaneus, also known as the heel bone, is the largest tarsal bone and bears the brunt of axial loading forces.
It is the most commonly fractured tarsal bone, accounting for approximately 60% of such injuries.
The most frequent cause is a high-energy impact, classically a fall from a height where the person lands on their feet, driving the talus into the calcaneus.

Option A: Fractures of the cuboid bone are rare and typically do not occur in isolation.
Option B: Navicular fractures are not the most common acute traumatic fractures of the tarsals.
Option C: While fractures of the talus are common and serious, they are less frequent than calcaneal fractures.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Anatomy and fracture patterns of the tarsal bones as background academic context rather than a clinical decision trigger.
A calcaneal fracture is a 'red flag' for high-energy trauma. Nurses should have a high index of suspicion for associated injuries, particularly compression fractures of the lumbar spine (in 10-15% of cases).
Due to significant swelling, meticulous neurovascular assessment of the affected foot is a critical nursing intervention to monitor for compartment syndrome.
What if? If the patient was a marathon runner with gradual onset of midfoot pain over several weeks, the most likely diagnosis would shift from an acute calcaneal fracture to a navicular stress fracture.

How to Approach the Question

First, identify the keywords in the question: 'tarsal bones' and 'most commonly fractured'. This indicates a factual recall question about foot anatomy and epidemiology.
Mentally visualize or list the tarsal bones of the foot: talus, calcaneus, navicular, cuboid, and three cuneiforms.
Consider the function and location of each bone. The calcaneus is the large bone that forms the heel and is the first point of contact in many impact scenarios.
Recall common injury mechanisms. A fall from a height is a frequent cause of major trauma, and the primary bone affected in such a fall is the calcaneus due to axial loading.
By linking the high-frequency injury mechanism (fall from height) to the bone that absorbs that impact (calcaneus), you can deduce it is the most commonly fractured.

Concept Tested & Keywords

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E6 Anatomy BDChaurasia V2 10e Part 1 pp. 59-61, 57-59

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