Fractures occurring to the bones of the foot and ankle are among the most common fractures that occur to people. The majority of these fractures occur as a single event, such as a trip or fall. However, repetitive stress on the foot and ankle can also lead to a fracture.
Most fractures can be diagnosed with x-rays, however some require specialized imaging such as CT scans to help plan for surgery.
Fractures of the foot and ankle include:
Ankle fractures are very common. Younger patients most commonly sustain a broken ankle while playing sports. Older patients are more likely to injure themselves tripping off a curb or falling while walking down stairs.
An ankle fracture refers to a break that occurs to the lower end of the tibia and fibula bones. These 2 bones contact the talus bone in the foot, and comprise the ankle joint. The tibia bone is the larger bone that composes the top and inner side of the ankle joint. The fibula is the smaller, outer bone of the ankle. The fibula, is most commonly fractured.
In a more severe fracture, the inner portion of the tibia will be fractured in addition to the fibula. In the most severe form of ankle fracture, the lower end of the tibia will be broken as well. This latter fracture is especially serious because it involves the weight-bearing portion of the joint, and injuring this area puts one at extremely high risk of developing arthritis of the ankle joint.
The bones of the midfoot link the ankle joint to the forefoot. These are not commonly fractured although the consequences can be grave if fracture does occur, particularly if they are not diagnosed. This fracture occurs when the foot and ankle is suddenly twisted or during a high impact such as an auto accident. Many require surgery, particularly if they are displaced. Fractures in this part of the foot can lead to arthritis.
Heel (calcaneus) fractures
The heel bone, known as the calcaneus, can be broken in a fall from a height or from a motor vehicle accident. This is a very serious and complicated type of fracture, because the calcaneus usually breaks into many different fragments, and often requires surgical repair. Even with a less serious calcaneus fracture, there is often residual stiffness in the foot and ankle following this type of break. Recovery from a calcaneus fracture takes 4 to 6 months. Due to the complicated nature of this type of injury, a calcaneus fracture is best treated by an Orthopedic Surgeon with considerable experience treating this type of fracture.
The toe bones in the foot are known as phalanges. The phalanges of the foot are most commonly fractured when kicking the leg of a chair or table while walking barefoot in the house. In a severe fracture, the toe will be angled out of place and will need to be “set” back straight into position (usually done at the ER or in an Orthopedist’s office, or sometimes by the injured person). Despite their small size, toe fractures can me quite painful.
Non-surgical – Most fractures of the toes and metatarsals can be treated non-operatively with a hard sole shoe and taping of the toes. Weight-bearing is allowed for these types of fractures and typically the patient resumes most activities by 6 to 12 weeks. Fractures of the ankle, heel bone and midfoot may be treated non-operatively, particularly if there is no displacement of the fracture fragments. However, these types of fractures usually require immobilization in a cast as well as a period of non-weightbearing on the affected limb.
Surgical – Most displaced fractures of the ankle, heel and midfoot require surgery to achieve the most optimal result. While many fractures of the ankle are routine and can be treated by any orthopedic surgeon, some fractures, particularly of the heel and midfoot require a surgeon with specialized expertise in either trauma surgery or foot & ankle surgery due to high risk of complications in treating these fractures.
Dr. Chapman is experienced in treating of all types of fractures of the foot and ankle, including high energy, Level 1 trauma. He also provides routine general orthopedic fracture care as well.