Fracture Care

What is a foot fracture?

With 26 bones in a single foot, almost any of them can be broken. Many breaks or fractures don't need surgery, or even a cast. They will heal on their own with some support. When a foot is fractured, the site of the fracture usually is painful and swollen. The site of the fracture will determine the course of treatment, if needed, including:

• Ankle joint fractures. These fractures may be serious and require medical care right away. Ankle fractures usually require a cast. Some require surgery if the bones are too separated or misaligned.
• Metatarsal bone fractures. Fractures of the metatarsal bones, located in the middle of the foot, often don't require a cast. A stiff-soled shoe may be all that is needed for support as the foot heals. Sometimes surgery is needed to correct misaligned bones or displaced segments.
• Sesamoid bone fractures. The sesamoid bones are 2 small, round bones at the end of the metatarsal bone of the big toe. Usually, padded soles can help relieve pain. But sometimes the sesamoid bone may have to be surgically removed.
• Toe fractures. Fractures of the toes often can heal with or without a supportive hard shoe.

The feet and ankles work together to provide support and mobility to the body. A foot or ankle sprain is a soft tissue injury. Most often, a sprain occurs when an injury pulls, stretches, or tears the ligaments that connect bone to bone. A fracture is actually a break in the bone.

Causes

Injuries are the most common causes of foot and ankle sprains and fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle sprains and fractures. Basketball players are prone to ankle sprains, and runners may develop stress fractures of the ankle or foot. Gymnasts and dancers may also develop stress fractures.

Tripping or stumbling on uneven ground is another common cause of foot and ankle sprains and fractures.

Symptoms

Pain, swelling, bruising, and difficulty walking on the affected foot or ankle are the most common symptoms of a sprained or fractured foot or ankle.

Diagnosis and Treatment

Our doctors will carefully examine your feet and ankles and take a complete medical history. They may also order tests, including an X-ray, ultrasound, or MRI, to determine the extent of your injury. If you have a fracture that's clearly visible on X-ray, you may not need additional testing. Ultrasounds and MRIs are useful for finding soft issue injuries (including torn ligaments) and stress fractures.

Treatment will depend on your injury. If you have a broken bone, your podiatrist may attempt to "reduce" the fracture, which means lining up the ends of the bones so they can heal properly. (You'll be given a local anesthetic to numb the area first.) If the fracture is "unstable," meaning that the ends of the bone do not stay in place after a reduction, surgery may be needed. Podiatrists can use metal plates and screws to fix broken bones.

Stress fractures are treated with rest and immobilization. You will be instructed to stay off the affected area until healing is complete. Crutches and/or a special "boot" or cast may be used to immobilize the area.

Sprains are also treated with a period of immobilization. Depending on the extent of your sprain, you may be able to resume activity fairly quickly, or you may need to wear a soft cast or special "boot" and use crutches for a period of weeks.

Professional athletes may undergo surgery to repair torn ligaments.

Oral anti-inflammatory medication, such as ibuprofen, can be used to decrease pain, swelling, and inflammation.