Broken Foot

What is a foot fracture?

A foot fracture is a broken foot injury that occurs from trauma to the bone. Many forms of trauma can cause a foot fracture, including car accidents, falls, etc., while risk factors like an unhealthy lifestyle or a separate medical condition can make a broken foot more likely to occur. Fractures are sometimes easy to identify, while others will require several forms of testing to obtain a diagnosis.

There are several different types of foot fractures, each with its own range of causes, symptoms, and treatment options. The seriousness of this injury will vary widely depending on how the bone was broken. A foot fracture can be a tiny crack in a toe bone or a broken bone that pierces the skin. As a result, treatment options for a broken foot can also vary, some requiring surgery and implant plates and others requiring a brace and temporary crutches.

What are the causes and risk factors for a broken foot?

A broken foot can have a variety of causes and risk factors. The most obvious cause is acute physical trauma. This can happen as the result of a car accident, a fall, a misstep, or impact from a heavy weight. Sometimes, this trauma will result in a foot crush injury, a potentially serious condition that requires immediate medical attention.

That said, trauma does not need to be acute to cause a broken foot. Overuse is a common cause for certain foot injuries, like stress fractures. These occur when repetitive force, such as running long distances, causes small cracks over time. Participating in high-impact and endurance sports can put athletes at a greater risk for developing this type of broken foot.

There is also a range of factors that put individuals at a higher risk of breaking a foot. In addition to participating in high-impact and endurance sports, using an improper technique during a sport, or using equipment that is not properly fitted, can contribute to stress fractures and falls. Additionally, the following lifestyle changes and experiences can increase a person’s risk of breaking a foot.

• Working in certain occupations. Some work environments, like construction sites, put workers at a higher risk of injury. This can include anything from falling to dropping a heavy object on the foot.
• Suddenly increasing activity level. Suddenly boosting the frequency or duration of physical activity can increase the risk of a stress fracture.
• Having a medical predisposition. Some conditions, like osteoporosis, can increase a person’s change of experiencing a foot injury.
• Living in a cluttered or poorly lit environment. Clutter and low lights can hide dangerous objects, which can lead to falls and foot injuries.

How do you know if your foot is broken? What are the symptoms?

A broken foot can be very difficult to diagnose without the help of a physician. Knowing the difference between a bruise and a stress fracture, or a broken foot and a sprain, is difficult, especially if you haven’t experienced either in the past. The symptoms of these conditions overlap, and while breaks and fractures tend to be more painful for a longer period, most foot injuries will have the following symptoms.

• Bruising
• Swelling
• Tenderness
• Throbbing pain
• Pain that increases with activity
• Difficulty in walking or bearing weight

If the broken foot is severe, you may be able to know it is a break because of an obvious deformity. If the pain does not get better with time, and if the swelling does not go down, you likely have a broken foot.

One good metric for determining whether you have a broken foot is to remember the sound it makes during the injury. If you have a sprain, you will likely hear a popping sound. If you have a break or fracture, you are more likely to hear a cracking sound. This will not be enough to make a definitive diagnosis, but it can be helpful to a doctor during a physical examination.

For almost all foot injuries, an X-ray will be necessary to determine whether you have a broken foot or a different type of injury. The X-ray will show whether the bone is fractured and to what extent it is broken. Then, they will either recommend additional testing and imaging or begin the process of creating a treatment plan.

What are the different types of foot fractures?

The type of foot fracture you sustain will depend on the injury site and the way in which it was broken. There are several common types of fractures that can occur in nearly any bone in the body.

• Stable fracture, or when the broken ends of the bone line up.
• Compound fracture, or when the skin is pierced by a broken bone.
• Oblique fracture, or when the fracture has an angled pattern.
• Transverse fracture, or when the fracture line is horizontal across the bone.
• Comminuted fracture, or when the bone shatters into three or more pieces.

In the foot, these fractures can happen to nearly any bone – the metatarsal bones, phalanges, heel bone, anklebone, etc. The location of the fracture will determine the course of treatment.

• Ankle Joint Fracture – These breaks are often serious and require immediate medical attention. Ankle fractures typically require a cast, and some may need surgery if the bones are very separated or misaligned.
• Sesamoid Bone Fracture – The sesamoid bones are the two small, round appendages at the end of the big toe. Padded shoe soles can help relieve pain, but this bone may need to be surgically removed.
• Metatarsal Bone Fractures – Located in the middle of the foot, the metatarsal bones do not usually require a cast when they break.
• Toe Fractures – This is one of the more common broken foot injuries. They may or may not require a cast, depending on the severity of the break.
• Crushed Foot Injury – This injury occurs when the foot is crushed between two hard surfaces, such as when dropping a very heavy object. These injuries are typically extensive and often have a combination of fractures in different parts of the foot.

What are the most common foot fractures?

Fractures are common in the fifth metatarsal, especially in adults. This is the long bone on the outside of the foot. This bone is prone to two types of foot fractures: an avulsion fracture, which occurs when a small piece of bone is pulled off the main portion by a ligament or tendon, such as when an ankle rolls; and a jones fracture, which is a stress fracture or acute break in the fifth metatarsal. In children less than 4 years old, the first metatarsal is the most common foot fracture.

Additionally, stress fractures most commonly occur in the second and third metatarsals, as well as the heel, in the outer bone of the lower leg, and on the top of the foot.

That said, there are 26 bones in the foot, and each can experience a fracture depending on your lifestyle or injury. While metatarsal breaks and stress fractures are the most commonly experienced, any type of severe swelling and pain should necessitate a trip to the doctor.

Will you need surgery for a broken foot?

Surgery for a broken foot is not always a doctor’s first treatment option, but it can be necessary in some cases. Multiple stress fractures, severe fractures, and foot deformities will likely require surgery. This procedure will typically insert screws, pins, rods, or plates into the body, which should bolster the foot’s structure and aid in the healing process. The materials may be removed after the fracture heals, or if they are prominent or painful.

While not a surgery, a reduction procedure may also be necessary to jump-start the healing process. A reduction is when the doctor manipulates the pieces of bone back into their proper positions during a displaced fracture. If there is a severe amount of pain or swelling, you may need a muscle relaxant, a sedative, or a general anesthetic before the procedure.

If surgery is not necessary, your doctor will prescribe a different treatment. This often includes a pain reliever and/or physical therapy, sometimes in addition to a cast. A single stress fracture should heal with rest and lifestyle changes, and broken toes can be treated symptomatically. The most common form of treatment for a broken foot is immobilization. This typically requires a cast, but minor foot fractures may only require a removable brace or shoe with a stiff sole.

How long does it take for a broken foot to heal?

A range of factors will determine the amount of time your broken foot needs to heal. Most foot fractures will require between 6 and 8 weeks to heal, but less severe injuries should take between 4 to 6 weeks. On the other end of the spectrum, a surgically treated broken foot could take several months to heal. The characteristics that factor into this healing period include, but are not limited to:

• The location of the break
• The severity of the break
• The type of break
• The recommended treatment (surgery vs. cast)
• The number of breaks
• How closely you follow treatment guidelines

Remember that returning to physical activity too soon after the injury can risk poor healing, re-injury, or a complete fracture. If the pain or swelling returns, see your doctor.

Broken foot bones can also cause complications over time. While uncommon, fractures that extend into a joint can cause arthritis. Bone infections can also occur if there is an open fracture, and nerve or blood vessel damage can happen if the foot trauma tears them. These complications can take longer to heal.