Foot and Ankle Fracture

There are several different types of foot fractures, classified by location:

• Ankle joint fractures: When you break one or more of the three bones in your ankle joint (the tibia, fibula, and talus), it is an ankle fracture. There are numerous types of ankle fractures, the most common being a lateral malleolus fracture (a break in the knobby bump on the outside of the ankle). Ankle fractures typically require a cast, and more severe injuries may require surgery.
• Metatarsal bone fractures: The metatarsal bones are located in the center of the foot. One of the most common foot injuries is a fifth metatarsal fracture, which is the long bone on the outside of the foot that connects to the smallest toe. Sometimes surgery is recommended if your bones are displaced, however, these fractures are often resolved with a cast.
• Sesamoid bone fractures: The sesamoid bones are the two small round bones at the base of the big toe. A j-shaped pad worn around the sesamoid can help relieve pressure and therefore pain, and other orthotic devices may need to be worn as the fracture heals. Occasionally, a sesamoidectomy may be necessary to reduce pain and inflammation.
• Toe fractures: A fracture in this area is most often caused by stubbing your toe or dropping something heavy on your foot. It can typically be treated by taping the fractured toe to a neighboring toe, but severe fractures (especially on the big toe) may require a cast or even surgery.

A foot or ankle fracture can happen from something as innocuous as stepping off a curb and twisting the foot, or stumbling in your own home. It can also be due to a car accident, fall, or taking a direct hit to the foot and ankle.

There are a few ways an foot or ankle fracture can happen:

• Serious fall
• Sports injury (stress fractures of the foot and ankle are common in athletes such as runners, due to repetitive motion and overtraining)
• Motor vehicle accident
• Twisting or “rolling” the ankle
• Direct blow to the ankle

Your doctor will begin with a physical examination to evaluate your range of motion, points of tenderness, and walking gait. If there are indications of a fracture, your doctor will likely order one of the following imaging tests:

• X-ray
• Bone scan
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)

The treatment for a foot or ankle fracture will vary depending on the site and severity of the injury. All ankle fractures and most foot fractures require some level of care to heal. For example, a stress fracture may be treated with an orthotic device or cast. It typically does not require surgery.

However, if your fracture is displaced (the bones have come out of alignment), you may need to undergo a process called reduction, where your doctor repositions the two ends of the fracture back together. Depending on the fracture, the bone may be immobilized with a cast, removable brace, or special boot.

In some cases, surgery may be necessary. An orthopedic surgeon may need to use pins, pins, or screws to keep the bone fragments together while they heal.