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Foot Fractures

by Danielle Campagne, MD

Fractures of the foot may occur in the toes, the middle bones of the foot (metatarsals—see Metatarsal Fractures), the two small round bones at the base of the big toe (sesamoids—see Sesamoid Fractures), or the bones at the back of the foot, including the heel bone (calcaneus—see Fractures of the Heel Bone).

Foot fractures are common. They may be caused by falls, twisting, or direct impact of a foot against a hard object. Foot fractures cause considerable pain, which is almost always made worse by attempting to walk or put weight on the foot.

Where Foot Fractures Occur

Foot fractures are common. They may occur in the

  • Toes (phalanges), particularly the big toe (hallux), shown below

  • Middle bones of the foot (metatarsals)

  • Two small round bones at the base of the big toe (sesamoids)

  • Bones at the back of the foot: cuneiform, navicular, cuboid, talus, and heel bone (calcaneus)

Diagnosis

  • Usually x-rays

Diagnosis usually requires x-rays, except for certain toe fractures. Rarely, computed tomography (CT) or magnetic resonance imaging (MRI) is required.

Treatment

  • A cast or a specially designed shoe or boot

  • Often instruction not to put weight on the foot for a time

  • Physical therapy

Treatment depends on the bone fractured and the type of fracture, but it usually involves placing the foot and ankle in a cast or a specially designed shoe or boot with open toes, Velcro fasteners, and a rigid sole to protect the foot from further injury.

People are often instructed not to put any weight on the foot for a period of time. How long they have to wait depends on the injury and can take up to several months. Often, doctors encourage people to move the foot and ankle as soon as doing so is not too painful.

Physical therapy is often required. It consists of specific exercises to improve flexibility and movement of the affected foot and to strengthen supporting muscles.

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