[6][2] This movement may occur when changing direction while the heel is off the ground such in dancing, tennis, or basketball.

[5] Due to poor blood supply in this area, the break sometimes does not heal and surgery is required.

Diagnostic X-rays include anteroposterior, oblique, and lateral views and should be made with the foot in full flexion.

If, however, it enters the tarsometatarsal joint, then it is likely an avulsion fracture caused by pull from the fibularis brevis tendon.

[19] If an injury to that area has occurred, the physician is often able to interpret certain radiographic clues to make the differentiation.

[20] For persons who are not athletes, surgery might not be recommended unless healing does not occur after a trial of cast treatment.

[citation needed] These zones can be identified anatomically and on x-ray adding to the clinical usefulness of this classification.

Other reviews of the literature have concluded that conservative, non-operative, treatment is an acceptable option for the non-athlete.