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FOOT FRACTURE IN ADULTS

(OPEN FRACTURE DISLOCATION, TARSOMETATARSAL JOINT)
Foot Fracture in Adults

WHAT YOU NEED TO KNOW:

What is a foot fracture? A foot fracture is a break in one or more of the bones in your foot. Foot fractures are commonly caused by trauma, falls, or repeated stress injuries.

Foot Anatomy

What are the different types of foot fractures?

  • Nondisplaced: The bone cracks or breaks but stays in place.

  • Displaced: The bone breaks into 2 pieces.

  • Comminuted: The bone is broken in many different places.

  • Open fracture: The broken bone breaks through your skin.

What are the signs and symptoms of a foot fracture?

  • 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 breaks in the skin of your injured foot

  • Decreased ability to move your foot or walk

  • A different shape to your foot

How is a foot fracture diagnosed? Your healthcare provider will examine your foot. He may touch your foot to see if you have decreased feeling. He will check for any open breaks in the skin. He may check your foot movement. You may need any of the following tests:

  • X-ray: This is a picture taken to check your foot for broken bones. You may need to put weight on your injured foot to take the x-ray.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your foot. The pictures may show broken bones or other foot injuries. You may be given dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your foot. An MRI may show a fracture or other foot injuries. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. 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.

  • Bone scan: You are given a small, safe amount of radioactive dye in an IV. Pictures are then taken of your foot bones to look for fractures.

How is a foot fracture treated? Treatment depends on what kind of fracture you have and how bad it is. You may need any of the following:

  • Boot, cast, or splint: A boot, 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 further damage to your foot.

  • Medicine:
    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Tetanus shot: This is a shot of medicine to prevent you from getting tetanus. You may need this if you have breaks in your skin from your injury. You should have a tetanus shot if you have not had one in the past 5 to 10 years.

  • Surgery: You may need surgery if you have a severe foot fracture or if your fracture does not heal with other treatments. If you have an open fracture, you may need debridement before your surgery. This is when your healthcare provider removes damaged and infected tissue and cleans your wound. Debridement is done to help prevent infection and improve healing. You may need any of the following:
    • External fixation: Your healthcare provider will put screws through your skin and into your broken bones. The screws will be secured to a device outside of your foot. External fixation holds your bones together so they can heal.

    • Open reduction and internal fixation: During this surgery, your healthcare provider will make an incision in your foot to straighten your broken bones. He may use wires, screws and metal plates, or nails to hold your broken bones together.

    • Pin fixation: Your healthcare provider may need to use metal wire pins to straighten the broken bones in your foot. The pins will hold the broken pieces of bone together. Pins will be placed through your skin and into your bone using a small drill.

  • Traction: Traction pulls on the bones to put them back into place. A pin may be put in your bone or cast and hooked to a traction device. Weights are hung from the traction device to help pull the bones into the right position.

What are the risks of a foot fracture?

  • During surgery, the nerves, tissues, and blood vessels in your foot may be damaged. You may have numbness or weakness in your foot and toes. Your foot may not heal properly or work as well as it did before your injury. Screws, nails, or pins used during your surgery may come loose, and you may need another surgery. You may get an infection. You may get a blood clot in your leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

  • Without treatment, your broken foot may not heal. If your fracture heals on its own, your foot may be deformed. You may not be able to move your foot as well as you did before your injury. You may have pain, weakness, or loss of feeling in your foot. You may be at risk for blood clots. You may have tissue damage, and you may get an infection. Severe infections may lead to a bone infection, and you may need your foot amputated.

What can I do to help my foot heal?

  • Rest: You may need to rest your foot and avoid activities that cause pain. For stress fractures, you will need to avoid the activity that caused the fracture until it heals.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your foot for 15 to 20 minutes every hour as directed.

  • Elevate your foot: Raise your foot at or above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your foot on pillows or blankets to keep it elevated comfortably.

  • Physical therapy: Once your foot has healed, a physical therapist can teach you exercises to help improve movement and strength, and to decrease pain.

When should I contact my healthcare provider?

  • 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 about your condition or care.

When should I seek immediate care or call 911?

  • 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 the cast was put on.

  • Your wound is draining fluid or pus.

  • Blood soaks through your bandage.

  • Your leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and short of breath.

  • You have chest pain when you take a deep breath or cough. You may cough up blood.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.