Foot and Ankle Fracture Treatment

What You Need To Know

Understanding foot and ankle fractures, how they happen, and when to seek care.

Fractures of the Foot and Ankle

A fracture is a break in the bone, as opposed to a soft tissue injury such as a sprain or strain. There are 26 bones in each foot and ankle, all of which undergo significant strain and pressure as you move throughout the day. When bones receive more force than they can endure, they can break. The usual areas of the feet that suffer broken bones are the toes, the top of the foot, the underside of the foot and the ankle.

Fractures fall into two general categories. In a simple or closed fracture, the bone does not come through the skin and it is a single break. In a compound or open fracture, the bone may break through the skin, or more than one bone may be broken. Stress fractures are tiny hairline breaks caused by overuse, developing over time rather than suddenly. The metatarsals, sesamoids, and toes are especially prone to stress fractures in runners and athletes.

A fractured foot or ankle will cause pain, bruising and swelling, and it will be difficult to walk on the injured foot. Other signs include severe pain immediately after the injury, a snapping or breaking sound, reduced range of motion, tenderness, and a visible deformity where bones look out of place.

Injuries are the most common causes, especially during sports like basketball and football. Trauma, falls, dropped objects, and sudden twists can all cause a break, while arthritis, osteoporosis, overuse, and extra weight raise the risk. Because fractures and sprains share similar symptoms, any suspected break should be assessed by a podiatrist as soon as possible for an accurate diagnosis and effective treatment.

Treatment, Recovery, and Rehabilitation

Until you can see a foot and ankle specialist, use the RICE method at home. Rest the injured foot, since walking may cause further injury. Ice the area for 20 minutes at a time, with a thin towel between the ice and the skin, and wait at least 40 minutes before icing again. Use an elastic wrap for compression, and elevate the foot slightly above the level of your heart. Ibuprofen can help relieve pain and swelling. If the bone is pushing through the skin, do not touch it and get emergency care right away.

To diagnose a fracture, your provider evaluates your overall condition, asks how the injury occurred, and gently presses different areas of the foot to locate the pain. Imaging tests such as an X-ray confirm or rule out a fracture, while an ultrasound or MRI can help identify stress fractures and soft tissue injuries. Because a Jones fracture may not show up on initial X-rays, additional imaging studies may be needed.

Treatment depends on the location and severity of the injury. Less severe fractures typically require immobilization with a cast, cast boot, or stiff-soled shoe for about 6 to 8 weeks, and crutches may be needed to keep weight off the foot. Bone stimulation may be used to speed healing of certain fractures, such as Jones fractures.

More complex, displaced, or unstable fractures may require surgery. Skilled foot and ankle surgeons reposition the bones and use plates, screws, or rods to hold them in place while they heal. After the bone heals, a physical therapy program helps restore strength and mobility so you can return to your normal activities.