Foot fracture fixation
The treatment that is best for your foot fracture depends on a number of factors, including age, present health, health history with fractures, the severity and location of the fracture and past experience with other medications and treatments. Foot fracture, which is a break in one or multiple bones in the foot, accounts for 10 percent of all fractures in the body.
A foot fracture can immobilize you and, if not treated quickly, can lead to permanent disability. If you have any reason to suspect that your foot has been fractured, it is important to avoid at-home care and to seek medical attention. To best diagnose your condition, your doctor will ask some questions about your injury and past history with similar injuries, as well as perform a physical exam. Because many foot fractures can be misdiagnosed as ankle sprains or breaks, one or more of these tests will be done to determine the exact location of the breakage:
- X-ray (radiograph) – The first test to be done will be an X-ray. Electromagnetic radiation will pass through your foot and ankle to highlight the exact location of the injury. Bone stands out in a radiographic image because it absorbs the radiation, making it easier to see where breaks or fractures have occurred.
- Computed tomography scan (CT or CAT scan) – A CAT scan combines X-ray and computers and is used on rare occasions for this type of injury. In some cases it can show minor breakages not seen clearly on an X-ray.
- Magnetic resonance imaging (MRI) – Different from X-rays and CAT scans, MRIs use a magnetic field and radio waves aimed at the foot and ankle, causing them to vibrate to create an image. Once this image has been taken, a computer translates the rate of these vibrations and transforms them into a high-definition image.
For most foot fractures, such as those that occur in the toes, treatment via nonsurgical means is typically sufficient. In some cases, the doctor will recommend rest and ice to overcome the injury. In these cases, the patient will use crutches to help avoid putting weight on the affected bone. Your doctor also may recommend wearing only flat-bottomed shoes. For more severe breaks that still do not require surgery, a cast or splint may be used to stabilize the bones as they heal.
In some severe cases, a foot fracture may necessitate surgery to reduce the risk of a permanent deformity. The aim of foot fracture surgery is to reconnect the bone so it is stabilized and heals correctly without permanent damage. The majority of foot fractures are treated surgically using one of these techniques:
- Internal fixation with pins – In some cases, pins may be placed around the broken bone to hold it in place as it reconnects. These are used for the smaller bones in the foot.
- Internal fixation with plates and screws – If pins are not sufficient stabilizers for the small bones in the foot, a plate may be used instead. This plate is then screwed into place to keep it stable as the foot heals.
Much foot fracture research focuses on the diagnosis of the injury. Because the small bones in the foot heal quickly, quick diagnosis and treatment are paramount. Without this, many people have been left with deformities in their feet that cannot be later corrected.
One of the most common misdiagnoses involving foot fractures are ankle sprains. This is found mostly in talar dome fractures, or breakages in the uppermost part of the foot. The injury is usually a result of inversion. While these injuries typically do not take a lot to treat, misdiagnosis has resulted in long-term disabilities in the affected foot.
The difficulty of seeing these fractures on an X-ray is the primary cause of misdiagnosis. For this reason, more doctors are beginning to do additional testing, such as CAT scans and MRIs, to try to diagnose this fracture. However, the symptoms are so similar to that of an ankle sprain that a foot fracture is difficult to detect. Much research is being done in the way of proper detection using the X-ray imaging technique. With advancements in this technology, as well as further studies on how to better detect this type of fracture, doctors are improving their methods of diagnosing foot fractures so these injuries do not cause any long-term negative effects.
As research on diagnosis of foot fractures is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.
The multidisciplinary team of trauma and fracture experts at Northwell Health Orthopaedic Institute performs foot fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.