Foot & Ankle Fractures

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Fractures of the foot and ankle happen quite frequently, primarily due to  stresses and strains applied to the foot as well as the simple fact that  the foot seems to be a focal point for trauma.  The purpose of this  page is actually to discuss various types of fractures that occur  primarily in the foot.  

Since fractures can occur any where in the human body, we will that discuss the mechanism and  treatment of foot and ankle fractures in general.

• Tenderness over the injured area
• Foot pain that increases when you try to stand or walk
• Numbness in your foot or toes
• Cracking sounds when you move your foot
• Swelling, bruising, blistering, or open skin breaks
• Trouble moving your foot or walking
• Foot shape that is not normal

Your healthcare provider will examine your foot and check for  decreased feeling. He or she will check for any open skin breaks. He or  she may check your foot movement. You may need any of the following  tests:

• An x-ray, CT scan, or MRI may be used to check for a broken  bone or other injury. Contrast liquid may be used to help your foot show  up better in the pictures. Tell the healthcare provider if you have  ever had an allergic reaction to contrast liquid. Do not enter the MRI  room with anything metal. Metal can cause serious injury. Tell the  healthcare provider if you have any metal in or on your body.

• A bone scan may be used to check for a broken bone. You will  be given a small amount of radioactive dye in an IV. Pictures will then  be taken of your foot.

Treatment depends on the kind of fracture you have and how bad it is. You may need any of the following:

• A cast, or splint may be put on your foot and lower leg  to decrease your foot movement. These work to hold the broken bones in  place, decrease pain, and prevent more damage to your foot.
• Medicines may be given to prevent or treat pain or a  bacterial infection. You may also need a vaccine to prevent tetanus if  bone broke through the skin. A tetanus shot is given if you have not had  a booster in the past 5 to 10 years.
• Surgery may be used to put your bones back into the correct  position. Wires, pins, plates, or screws may be used to keep the broken  pieces lined up correctly and hold them together.

• The pain in your injured foot gets worse even after you rest and take pain medicine.
• The skin or toes of your foot become numb, swollen, cold, white, or blue.
• You have more pain or swelling than you did before a cast was put on.
• Your leg feels warm, tender, and painful. It may look swollen and red.

• You have a fever.
• You have new sores around your boot, cast, or splint.
• You have new or worsening trouble moving your foot.
• You notice a foul smell coming from under your cast.
• Your boot, cast, or splint gets damaged.
• You have questions or concerns about your condition or care.

The first thing a doctor will do is ask questions about how the injury occurred.  Then the doctor will examine the ankle, noting the amount of swelling and bruising.  The physical examination of the ankle may be   painful because the doctor needs to move the ankle to evaluate the pain  and swelling in order to make a proper diagnosis.

The  doctor may order an ankle X-ray to determine whether there  are any  broken bones. In addition to an ankle X-ray, your doctor may ask  for X-rays of the leg and foot to determine whether there may be other  related injuries. If the doctor suspects a stress fracture, the doctor  will ask for other imaging scans such as an MRI, which will show more  detail about the injury.  If there is a fracture, the doctor may also ask for a stress test, which is a special X-ray taken with pressure applied  to the joint.  This will help the doctor determine whether  surgery is  needed. 

Ankle fractures can be treated either surgically or nonsurgically. The doctor may treat the break without surgery by immobilizing the ankle if  only one  bone is broken, and if the bones are not out of place and the  ankle is  stable. Typically the doctor will do this by putting on a brace  that works as a splint or by putting on a cast. If the ankle is unstable,  the fracture will be treated surgically. Often, the ankle is made stable by using a metal plate and screws to hold the bones in place.  Following the surgery, the ankle is protected with a splint until  the  swelling goes down and then with a cast.

It usually takes at least six weeks for the bones to heal. Your doctor will probably ask you to keep weight off the ankle during that  time so  the bones can heal in the proper alignment.  Ligaments and tendons can  take longer to heal after a fracture is fully mended. It can  take as  long as two years to completely recover full pain-free motion and strength after an ankle fracture, although most people are able to resume their normal daily routine within three to four months.

After  the doctor has determined it is safe for you to start moving  your  ankle, you may need physical therapy to provide gait training, balance, strengthening, and mobility exercises. The therapist will  develop a  home program that you can use to regain your previous normal  function.  It can take several months to return to a normal walking  pattern without limping.