There are little data published regarding percutaneous fixation of calcaneal tuberosity avulsion fractures, but tongue-type calcaneal fracture literature can be extrapolated to these injuries because they can be considered the extra-articular form of a tongue-type calcaneus fracture. Both injuries involve similar considerations regarding skin compromise and need for urgent management with similar percutaneous techniques to minimize further soft-tissue injury. Percutaneous fixation of tongue-type calcaneus fractures was first reported by Weshues and Gissane in their description of the Essex Lopresti maneuver as an alternative to open approaches to minimize the risk of soft-tissue complications and flap necrosis and provide a means of improving reductions in smokers and diabetics who may not otherwise be good operative candidates.