Foot Fractures

The hind foot is separated from the midfoot by the midtarsal joint and the midfoot is separated from the forefoot by the lisfranc joint. 

Muscles, tendons and ligaments support the bones and joints of the feet enabling them to withstand the entire body’s weight while walking, running and jumping. Despite this, trauma and stress can cause fractures in the foot. 

Causes of Foot Fractures

Foot fractures commonly occur as a result of a fall, motor vehicle accident, dropping a heavy object on your foot, or from overuse such as with sports.

Extreme force is required to fracture the bones in the hind foot. Another type of foot fracture is a stress fracture, which occurs when repeated activities produce small cracks in the bones. 

Types of Foot Fractures

Foot fractures can involve different bones and joints and are classified into several types:

• Calcaneal Fractures: This type affects the heel bone and occurs mostly as a result of high-energy collisions. It can cause disabling injuries and if the subtalar joint is involved it is considered a severe fracture. 
• Talar Fractures: The talus bone helps to transfer weight and forces across the joint. Talus fractures usually occur at the neck or mid portion of the talus. 
• Navicular Fractures: Navicular fractures are rare and include mostly stress fractures that occur with sports activities, such as running and gymnastics, as a result of repeated loading on the foot. 
• Lisfranc Fractures: This type of fracture occurs due to excessive loading on the foot, which leads to stretching or tearing of the midfoot ligaments. 

Symptoms of Foot Fractures

The common symptoms of a foot fracture include pain, bruising, tenderness, swelling, deformity and inability to bear weight.

Diagnosis of Foot Fractures

Your doctor diagnoses a foot fracture by:

Medical History

Your doctor will ask questions about:

• Current symptoms and their severity
• If an injury was sustained
• Your medical history including family or genetic links
• Your current and past medications
• The impact of the problem on your occupation and lifestyle

Physical Examination

Your doctor perform comprehensive physical evaluation that will include:

• Examining the affected area for swelling, pain, bruising or other features
• Assessing your range of motion, walking pattern and other relevant features

Diagnostic Testing

Once your doctor has completed the physical examination further tests maybe required. These tests can help your doctor determine or eliminate possible causes. These can include:

• X-Ray
• Ultrasound (US)
• Computerised Tomography (CT)
• Magnetic Resonance Imaging (MRI)

Once a final diagnosis has been completed your doctor can discuss with you and recommend any treatment options.

Non Surgical Treatment of Foot Fractures

Treatment depends on the type of fracture sustained. For mild fractures, nonsurgical treatment is advised and includes

• Rest: Resting the affected area or pausing athletic activity until the symptoms have reduced
• Pain medication: Paracetamol or Nonsteroidal anti-inflammatory medications (NSAIDs) can relieve some pain or discomfort
• Acute injuries may require R.I.C.E.
• Rest: Rest the affected area as more damage could result from putting pressure on the injury.
• Ice: Ice should be applied over a towel to the affected area for 15-20 minutes every two to three hours during the day.
• Compression: Wrapping with an elastic bandage or an elasticated tubular bandage can help to minimize the swelling and provide support to the injured area.
• Elevation: Elevating the injured area above heart level will also help with swelling and pain.
• Walking Boot: A CAM or Moonboot may be required in the initial stages of treatment, along with crutches or a cane.
• Physiotherapy: A physical therapist / physiotherapist may recommend exercise training and bracing to strengthen the area of pain and reduce the symptoms. This process commonly involves having a patient engage in a series of helpful exercises.
• Shoewear modification: You may require accomodative or custom shoewear to help support your foot.
• Orthotics: Special shoe inserts may be prescribed that may help relieve the pain.

Surgical Treatment of Foot Fractures

Depending on the type of fracture, surgery may be recommended. This can involve either:

• Realignment of the fractures with plates and screws
• Fusion of the affected joints

What if Foot Fractures are Untreated?

If left untreated, foot fractures can result in pain, altered weight bearing, calluses and severely limited activity.