foot and ankle fractures

Foot and ankle fractures

A broken bone in the foot or ankle can occur at any time.  Frequently they occur when someone steps off a curb and rolls their ankle, or missteps down stairs.  Often someone feels a pop or hears a crack.  Sometimes when people are active and perform repetitive acts, they can have stress fractures, which occur over time instead of just one misstep.  

What to do if you have a foot or ankle fracture

It is very important to realize that a fracture takes at least six to eight weeks to heal with immobilization and rest, and avoidance of walking and driving.  Treating fractures takes a lot of discipline, as most people with fractures are active, not wanting to stop their activities.  Rest, elevation, and icing are all important parts of healing broken bones.  I often hear patients say "I didn't think it was broken because I could walk on it".  Just because you can walk on your foot and ankle, it doesn't mean it is not broken.  Don't procrastinate in having your injured foot or anke checked out, so you can get back on your feet with no long-term complications.

Common fractures of the feet and ankles

Broken toes

We always hear "there is nothing to do for a broken toe".  Not true.  Actually, it is very important to have x-rays taken to determine the extent of the fracture and if it involves a joint.  Also to determine if the fractured bone is out of alignment.  It is important to avoid bending the fractured toe.  If it is a fifth toe, it is very difficult to "buddy splint" the toe, however it really needs to be immobilized in order for the fracture to heal.  That means wearing a stiff-soled shoe to avoid getting up on the tiptoes, as well as avoidance of moving the toe from side to side.  If it is a toe #2, 3 or 4, the toes can be "buddy splinted" together to avoid movement of the broken toe.  Sometimes surgery is required, if the fracture involves a joint and if the fracture is displaced.  It is very important to have the fracture evaluated in order to have the best treatment and avoid complications such as arthritis.

Metatarsal fractures

A metatarsal is a long bone that is often fractured when the foot is traumatically twisted.  Usually people experience swelling and bruising with pain experienced with each step.  Again, it is very important to have x-rays taken to determine the extent of the fracture.  If it is displaced, it most likely will require surgery.  If it is in good position, it can heal with immobilization, usually in a camwalker boot, or sometimes casts are the best treatment.  

Stress fractures

A stress fracture can occur in any bone in your foot or ankle.  A stress fracture is a break in the bone that is not displaced, and usually is not a complete fracture.  That doesn't mean it doesn't need treatment.  If stress fractures are ignored and not treated, they can progress to complete fractures.  It is important to avoid bending the foot or ankle for six to eight weeks while healing, and usually a camwalker boot is the best treatment.  

Broken ankles

Usually when someone breaks an ankle, it is a traumatic experience with immediate bruising, swelling and pain.  I have many patients who come to me still in pain months after being seen at Urgent Care, and they were told that x-rays did not show any fracture.  Sometimes fractures don't show up until two or three months after an injury.  It is important to have follow-up x-rays.  Also, sometimes an MRI is the best way to diagnose the extent of the injury.  Ankles can even have fractures deep inside the joint, damaging the cartilage inside the joint.  It is important to know the extent of the injury in order to determine treatment.  Rest, ice, immobilization and avoidance of walking/driving is very important to heal your ankle injuries.