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Foot Fractures

A foot fracture, or break in the bone, can happen from numerous causes, including a fall, trauma, direct blow, overuse, or repetitive stress on the foot. The bones in the foot can break in different ways. There may be one fracture and the bone remains in alignment, or multiple breaks which can be unstable. Open fractures, when the bone breaks through the skin, carry the risk of infection.

Symptoms:

  • Tenderness
  • Inability to move the injured part
  • Bruising
  • Swelling
  • Deformity at fracture site
  • Inability to walk on the affected leg

Fractures are often viewed on x-ray. However, other imaging studies, such as MRI, CT, and bone scans, are sometimes ordered to better assess the fracture.
Some fractures, especially in the toes, can be treated with proper immobilization. Fractures that are out of alignment may require surgery to restore foot shape and allow proper healing.

Some types of foot fractures include:

Lisfranc (Midfoot): A lisfranc injury involves the structures in the middle of the foot and may include one or several ligaments or bones. This type of injury can occur even from a simple twist and fall or if someone steps on your foot when it’s flexed down. Appropriate treatment is imperative to reduce the risk of arthritis formation in the joint. Occasionally, only the ligaments are partially torn and the joints remain in alignment. Cast immobilization for 6 weeks may be suitable treatment. If there is a fracture present or the bones are out of alignment, surgery is typically recommended to reduce the risk of foot deformity and arthritis. Surgery for a Lisfranc injury includes reducing the bones into correct alignment and placing plates and screws to hold them in correct position. Severe Lisfranc fractures may not heal with this type of fixation and may require joint fusion to solidify the damaged bones into one. After surgery, you will be immobilized in a cast for 6 to 8 weeks to allow healing.

Stress fractures: A small crack in the bone typically caused by overuse or repetitive, high-impact activities. The most common site for a stress fracture is in the metatarsals, or the long bones in the foot that connect the toes. Rear foot distance runners, basketball players, dancers, and gymnasts are at an increased risk of developing a stress fracture in the foot. Other risk factors include: sudden increase in activity, improper shoe gear, and weakened bone due to osteoporosis or other disease. Foot pain from a stress fracture typically increases with weight-bearing activity and subsides with rest. Treatment for most stress fractures involves rest and avoiding high-impact, weight bearing activities until healing has occurred. Anti-inflammatory medication can help relieve pain and swelling. A walking boot or protective shoe may be recommended for comfort as well. Gradual return to activity and varying between high and low impact activities can reduce the chance of a recurrent injury.

Toe fractures: Severely stubbing your toe or dropping a heavy object on the toe can cause a fracture. Most toe fractures will heal without surgery. If there is injury to the nail or the broken bone is sticking out through the skin, it is important to seek medical attention immediately. If the bones are displaced, or out of alignment, they may need to be reduced, or put back into alignment for proper healing. If the toe-fracture is minor, taping the injured toe to the next one will provide support. Wearing a stiff-soled shoe, icing the foot, and taking anti-inflammatory medication will help relieve pain and swelling. Broken toes take approximately six weeks to heal. Most simple fractures will heal without complication. Some fractures that are displaced, in many pieces, or extend into the joint, are at risk for developing continued stiffness, pain, arthritis, and deformity.

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