The foot can be divided into 3 parts:
- The hind foot is comprised of two bones, the talus bone which connects to the bones of the lower leg, and the calcaneus bone which forms the heel.
- The midfoot is comprised of the navicular, cuboid, and three cuneiform bones.
- The forefoot is made up of five metatarsal bones and 14 toe bones called phalanges.
The hind foot is separated from the midfoot by the transverse tarsal joints and the midfoot is separated from the forefoot by the lisfranc joints. Muscles, tendons and ligaments support the bones and joints of the feet enabling them to withstand the entire body’s weight while walking, running and jumping. Despite this, trauma and stress can cause fractures in the foot. Extreme force is required to fracture the bones in the hind foot. The mechanism of injury, the amount of energy, and the position of the foot usually dictates the type and the severity of the fracture.
Types of foot fractures
Foot fractures can involve different bones and joints and are classified into several types. The most common include:
- Calcaneal fractures: This type affects the heel bone and occurs mostly because of high-energy collisions. It can cause disabling injuries and if the subtalar joint is involved it is considered a severe fracture.
- Talar fractures: The talus bone helps to transfer weight and forces across the joint. Talus fractures usually occur at the neck or mid portion of the talus.
- Navicular fractures: Navicular fractures are rare and include mostly stress fractures that occur with sports activities, such as running and gymnastics, because of repeated loading on the foot.
- Lisfranc fractures: This type of fracture occurs due to excessive loading on the foot, which leads to stretching or tearing of the midfoot ligaments.
- Cuneiform fractures: Commonly occur in conjunction with a Lisfranc fracture.
- Cuboid fractures: Can occur from direct force or from a twisting injury while the foot is pointing downward.
- Metatarsal fractures:Can occur as a stress injury or with overt trauma.
Foot fractures commonly occur because of a fall, motor vehicle accident, dropping a heavy object on your foot, twisting the foot while it is pointing down such as walking down stairs or literally falling out of high heeled shoes, or from overuse such as with sports.
The common symptoms of a foot fracture include pain, bruising, tenderness, swelling, deformity and inability to bear weight.
Dr. Mesnier diagnoses a foot fracture by reviewing your medical history and performing a thorough physical examination of your foot. Imaging tests such as X-rays, MRI or CT scan may be ordered to confirm the diagnosis. Navicular fractures can be especially difficult to diagnose without imaging tests.
Treatment depends on the type of fracture sustained. For mild fractures, nonsurgical treatment is advised and includes rest, ice, compression, and elevation of the foot. Your doctor may suggest a splint or cast to immobilize the foot. For more severe fractures, surgery will be required to align, reconstruct or fuse the joints. Bone fragments may be held together with plates and screws.
Physical therapy may be recommended to improve range of motion and strengthen the foot muscles. Weight bearing however should be a gradual process with the help of a cane or walking boot.