Fractures

Q & A

What is a Fracture?

The foot and ankle work together with the human body to provide balance, stability, movement, and propulsion. The complex anatomy of the foot and ankle consists of 26 bones, 33 joints, several muscles, tendons (which connect muscles to bones), ligaments (which connect bones to bones), and blood vessels, nerves, and soft tissue covering. All of the anatomical structures have a potential to be injured, but a fracture specifically refers to a break in the bone. 

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All fractures are not equal. There are many types of fractures that can occur in the foot and ankle that may be treated differently, either with surgery or non-surgical treatment. 

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Some examples include: 

• Toe fractures

• Metatarsal fractures 

• Stress fractures 

• Midfoot fractures 

• Calcaneal fractures 

• Ankle fractures

• Pediatric fractures

Causes

Injuries are the most common causes of foot and ankle fractures. Many fractures occur during sports. Football players are particularly vulnerable to foot and ankle fractures. Runners, gymnasts, and dancers may develop stress fractures of the ankle or foot which are overuse injuries. Tripping or stumbling on uneven ground is another common cause of foot and ankle fractures.

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Symptoms 

You may experience swelling, bruising, pain, and difficulty walking on the affected limb.

Home Care

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If you have  hurt your foot or ankle, and are unable to seek treatment for it right away, it is  best to err on the side of caution. The acronym RICE can help you remember what to do:

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• Rest—Rest the affected area. Stay off the injured foot or ankle until it can be fully evaluated. Walking, running, or playing sports on an injured foot or ankle may make the injury worse.

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• Ice—Apply ice to the affected area as soon as possible, and reapply it for 15–20 minutes every three or four hours for the first 48 hours after injury. Ice can decrease inflammation which directly reduces pain and discomfort. 

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• Compression—Wrap an elastic bandage (such as an Ace® wrap) around the affected foot or ankle. The wrapping should be snug, but not so tight as to cut off circulation. This also helps reduce swelling and pain. 

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• Elevation—Elevate the affected extremity on a couple of pillows; ideally, your foot or ankle should be higher than your heart. Keeping your foot or ankle elevated also decreases swelling.

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When to See a Podiatrist

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Increased pain, swelling, bruising, redness, or difficulty walking after an injury are definite signs that it's time to see a podiatrist. Dr. Tien is the leading foot and ankle specialist in Orange County trained to diagnose and treat fractures in individuals of all ages. If you've injured your foot or ankle, make an appointment today. She can determine the extent of the injury and develop a plan of care to get you back in the game (or back to your everyday life) as soon as possible.

Diagnosis and Treatment

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Dr. Tien will carefully examine your feet and ankles and take a complete medical history. She will also order imaging studies, including an X-ray, and occasionally advanced imaging (ultrasound, MRI or CT) to determine the extent of your injury. 

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Treatment will depend on your injury. If you have a broken bone, Dr. Tien may attempt to “reduce” the fracture, which means lining up the ends of the bones so they can heal properly in good alignment. (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. Dr. Tien can use metal plates and screws to fix broken bones.

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Depending on your injury, you may be placed in a splint, a cast, or a removable CAM boot. It is crucial to the recovery and prognosis of your injury to follow the weight-bearing instructions of your podiatrist. 

Prevention 

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Warming up prior to physical activity and wearing proper shoes can prevent ankle sprains and fractures.  Avoid running or walking on uneven surfaces.

Content credit: apma.org