[Objective] The focus of this paper is to explore the interactive relationship between tongue-type fractures and plantar medial avulsion (PMA) fracture by measurement in three-dimensional CT. [Methods] A retrospective review was performed at our hospital trauma centers to identify patients sustaining calcaneal fractures from January 2016 to January 2020. Radiographs and CT images were then reviewed to determine the Essex-Lopresti classification and presence of a PMA fracture. [Results] The review yielded 157 total patients with 73 (46.5%) tongue-type (TT), 48 (30.6%) joint depression (JD),and 36(22.9%) fractures not classifiable by the Essex-Lopresti classification.There were 62 patients with PMA fracture. In the TT group, 34(54.8%) of the patients had the PMA fracture whereas 11(17.7%) of JD and 17(27.4%) of nonclassifiable fractures demonstrated a PMA fragment (P<0.05). A Student t test was performed comparing the displacement in TT that had a mean displacement of (5.12±0.71)mm and JD that had a mean displacement of (4.83±0.33)mm (P >0.05), there was not a significant difference in the displacement of the PMA fragments in different types. [Conclusions] Plantar medial avulsion fractures occurred in the calcaneal fractures reviewed with a significantly greater proportion occurring in TT as opposed to JD. Plantar medial avulsion fractures tend to occurred in the TT calcaneal fractures with greater displacement. There may be clinical significance to identifying this fracture and changing treatment management; however, this requires further investigation.