Foot and Ankle Anatomy
The foot is made up of 26 bones, 19 are located in the toes (phalanges), 5 are the long bones of the foot (metatarsals). The midfoot has several small bones that form the medial and lateral arches. The rearfoot consist of the heel bone (calcaneus) and ankle joint bone (talus).
The ankle joint, or mortise, consists of the tibia and fibula. Each of these bones has corresponding ligaments that attach the foot to the ankle.
What is a Fracture?
A fracture is defined as a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.
Traumatic fractures are caused by a direct injury to a bone and are classified as either displaced or non-displaced. If a bone breaks but is in good anatomic alignment, often casting, and not surgery, is the recommended treatment. However, if the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated). Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required.
Signs and symptoms of a traumatic fracture include:
- Swelling and bruising which often increases the day after an injury.
- Pain at one specific location which is often intense and may lessen after a period of time.
- You may hear a sound at the time of the break.
- Sometimes after stubbing a toe, the toe will change direction often indicative of a fracture.
Incorrect Myth: “if you can walk on it, it”s not broken.” Evaluation by the foot and ankle surgeon is always recommended.
Toe fractures can usually occur when the foot strikes a hard object, either dropping on object onto the foot or kicking an object. Non-displaced fractures of the toes do not typically require a cast and can be immobilized with the use of a surgical shoe, boot or buddy splinted to an adjacent toe.
Similar to digital fractures, metatarsal fractures can be described as being displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that the fracture fragment is mal-aligned with respect to the remaining metatarsal. Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required.
Signs and symptoms of a traumatic fracture include swelling, redness, bruising and pain (often pinpoint).
A stress fracture occurs because of too much stress across the outside lining of the bone (cortical surface). Typically, this occurs when a person walks or runs excessively. Characteristics include pain, tender with swelling without bruising which is painful with activity and goes away with rest. When a developing stress fracture is recognized early, the person should stop activities that aggravate the fracture. The fracture should be treated properly to prevent a through and through break of the bone, prolonging the healing time. In more advanced and severe cases, crutches and a cast are necessary.
Treatment of Toe Fractures
Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the type of fracture but rarely require surgery.
Treatment of Metatarsal Fractures
Metatarsal fractures may be caused by trauma or chronic fatigue leading to a stress fracture. Stress fractures often require immobilization and/or a bone stimulator to heal. Displaced traumatic fractures of the foot require surgical correction.