A fracture of the foot can involve any one of 28 different bones. There are 14 phalanx, 5 metatarsal, 3 cuneiform, 1 navicular, 1 cuboid, 1 talus and 1 calcaneus bones present in each foot. In addition, there are two constant sesamoid bones found at the great toe that help with proper joint function. Different fractures can occur to each of these structures depending upon the mechanism of injury. Trauma intensity to the foot structures can result in various fracture patterns ranging from avulsion fractures to severely comminuted shattered fractures of the bone.
Immediate evaluation by a foot and ankle surgeon is imperative. If one is not available then the fracture should be evaluated by an emergency room physician. At your appointment the physician will likely take X-rays and may even ask for more advanced imaging studies such as a CT scan or an MRI. Your doctor will examine your foot and ankle for pain and deformity. Neurovascular status will also be evaluated to ensure that your blood vessels and nerves have not been compromised following your injury. Once your evaluation is complete, the initial treatment will consist of R.I.C.E:
- Rest: Staying off of the injured ankle to reduce the risk of further injury
- Ice: Applying ice to the area for 10-15 minutes per hour while awake will help reduce pain and swelling
- Compression: An elastic bandage like an ACE wrap may be used to help control swelling
- Elevation: Keeping the injured limb elevated at or above the level of your heart will help lessen swelling and the throbbing that may occur after the injury
After your physician has thoroughly assessed the extent of the foot injury, they may recommend one of several definitive treatment plans. Simple fractures may be amenable to walking in a protective cast boot (cam walker) for several weeks, while a badly displaced fracture may require surgical care. Your physician will likely immobilize your foot in a splint/cast or cast boot at your initial visit.