Foot and Ankle Fractures

There are 206 bones in the adult human skeleton, and 52 of them—more than a quarter of the total—are located in the feet and ankles alone. Feet are incredibly complex, and many of these small bones are responsible for helping bear our weight and propel us forward as we walk, run, and jump. When bones are subjected to repetitive stress, or a sudden impact force beyond what they can handle, they may crack or snap.

Bone fractures can occur anywhere on the foot—toes, forefoot, midfoot, heels, or ankles. All foot fractures, regardless of severity or location, should be examined and treated by a foot and ankle specialist as soon as possible.

Signs and Symptoms of Foot and Ankle Fractures

Common symptoms that could indicate a broken foot, ankle, or toe include:

• Pain
• Swelling
• Redness
• Bruising
• Deformity (parts of the foot look misaligned or out of place)
• Limping
• Difficulty bearing weight
• Difficulty moving the affected area

Types of Foot and Ankle Fractures

Fractures can be classified by nature of the break, severity, location, or any of several other categories. In the broadest sense, all fractures fall into one of two categories:

• Simple / closed: Broken bones remain inside the body.
• Compound / open: Broken bones break the skin, exposing bone and other tissues to the outside world.

More specific types and categories of fractures we see and treat include:

• Stress fractures. Rather than break outright, bones develop hairline cracks along the outer surface. Stress fractures are common in the weight-bearing metatarsal bones, and form in response to repetitive stress. If you continue to aggravate the injury, the cracks may worsen into more serious breaks.
• Stable fractures. In a stable fracture, the bone has been broken, but the broken ends of the bone and joints remain stable and in the correct position. If well-protected, stable fractures can usually be treated purely through immobilization rather than surgery. All stable fractures are simple / closed.
• Unstable fractures. If a fracture is unstable, bones have become displaced from their regular position, leaving the ends out of alignment. Unstable fractures usually require surgical treatment, although sometimes the ends of the bone can be manipulated back into position manually and then casted. All compound fractures and many simple fractures are unstable.
• Comminuted fractures. These serious fractures occur when a bone is shattered or splintered into several (at least 3) smaller pieces. Comminuted fractures usually require impacts of tremendous force, such as automobile accidents or falling from a great height.
• Avulsion fractures. In an avulsion fracture, a tendon or ligament pulls off a bone fragment at the site where it attaches to the larger bone. Avulsion fractures are more common in children than adults, due to the presence of soft areas of growing bone known as growth plates. They are also common in the fifth metatarsal bone along the outside of the midfoot, near the pinky toe.

Treating Foot and Ankle Fractures

Foot and ankle fractures should always be treated immediately by a specialist. Potential consequences of improper or insufficient treatment include delayed healing, non-union (the fracture does not heal due to lack of stability or blood flow), development of post-traumatic arthritis, or infection.

If you are in serious pain and/or the bone has pierced the skin, please call 911 for emergency care, then schedule a follow-up appointment with us as soon as possible.

Treatment for broken feet and ankles will vary depending on the nature of the injury and may include:

• RICE therapy. Otherwise known as rest, ice, compression, and elevation. Crutches may be provided to help you keep weight off the foot.
• Immobilization. The foot is placed in a cast, brace, or walking boot in order to protect and stabilize it during the healing process.
• Advanced therapies. Our physicians may recommend more advanced conservative therapies, such as shockwave therapy or regenerative medicine.
• Surgical reconstruction. More complicated or unstable fractures may require surgery to reposition the bones. Hardware such as plates, screws, or wires may be required inside (internal fixation) or outside (external fixation) the body in order to hold bones in place as they heal.

Do not delay treatment for any foot or ankle injury, especially if you suspect a fracture. Please contact the nearest office of the Northwest Extremity Specialists today.