Fractures in the foot and ankle can happen at any time and seeking immediate treatment is important to ensure healing takes place as quickly as possible. Fractures can range from small, hairline fractures to traumatic bone breaks and although minor fractures usually heal on their own, more serious and unstable fractures require surgery.
Fractures in the foot and ankle can happen at any time and seeking immediate treatment is important to ensure healing takes place as quickly as possible. Fractures can range from small, hairline fractures to traumatic bone breaks and although minor fractures usually heal on their own, more serious and unstable fractures require surgery.
The ankle is comprised of three bones: the two lower leg bones (tibia and fibula) and the talus. The three bones are articulated together and supported with a number of strong ligaments. The protrusions from the inner bone (tibia) form the medial/inner malleolus and the outer bone (fibula) forms the lateral/outer malleolus.
The tibia has an outer bump known as the posterior malleolus. Ankle fractures are the most common type of fracture in the lower limb and can vary from a very simple fracture to a complex injury. Simple fractures involve a break to one of the bones, whereas more complex fracture involve breaks in all three bones. These fractures commonly occur due to twisting and rolling.
Signs and Symptoms
Diagnosis
Following an examination X-rays and occasionally a CT scan maybe required.
Treatment
The treatment for each fracture is unique and will depend on the type of fracture, displacement and severity of injury. Non-displaced (where the bones are aligned despite being broken) and stable fractures can be treated in a plaster cast or a walking boot.
When surgery is required, cuts into the skin are made, the bones are re-aligned and held with specially designed metal plates and screws. The skin is then sutured and a plaster is then applied for between 2 and 6 weeks.
Prognosis
Depending on the severity of the ankle fracture the outcomes following treatment vary. Your consultant at the Windsor Foot and Ankle Clinic will discuss this in more detail before and after the operation.
Activity and time off work
Two weeks post surgery is usually required to rest and recuperate. Following this the patient can return to a desk job. Manual jobs may require between 6 – 12 weeks off.
The 5th metatarsal is the long bone on the outer border of the foot that connects to the little toe. The base of this bone is most commonly fractured and there are two types of fracture that can occur depending on the location of the fracture.
The first is an avulsion fracture and is due to the tendon pulling off the bone at the base. The second is known as a Jones fracture and occurs in an area where the blood supply to the bone is poorer. As a result if fractured they take longer to heal. The third type of fracture is a fracture of the shaft of the 5th metatarsal which maybe due to repetitive injuries/stress fracture.
Signs and Symptoms
Diagnosis
After an examination, the diagnosis is usually confirmed through an X-ray.
Treatment
Avulsion fractures can usually be treated without surgery and require a splint. Jones fractures can be treated without surgery in a walking boot, however if the fracture does not heal then surgery maybe required.
Stress fractures are relatively common in the lower limbs, and may affect almost any bone in the foot or leg. There is always an underlying cause, either intrinsic (brittle bones, poor biomechanics) or extrinsic (inappropriate footwear, training regime, running surface etc).
Signs and Symptoms
Non-resolving pain and swelling are usually the main symptoms of a stress fracture.
Treatment
Treatment is tailored to the individual fracture and therefore involves careful assessment of the cause. Usually relative rest or immobilisation is prescribed, but occasionally operative fixation of the fracture is required.
The part of the shin bone (tibia) that forms a joint with the ankle (talus) is known as the tibial plafond or pilon. Fractures in this area occur due to the ankle being forced up against the tibia and are normally as a result of high energy and can include falls from height or motor vehicle accidents.
Signs and Symptoms
Diagnosis
Following a thorough examination to exclude any additional injuries, x rays and often a CT scan are obtained.
Treatment
Initial treatment involves applying a plaster cast and elevating the limb until the swelling has subsided.
Most pilon fractures require surgery. For those that do not, a cast and splint maybe required for a total of 12 weeks. Surgery often involves making cuts to the skin, re-aligning the fractures and holding them in place with metal plates and screws, the skin is then sutured over and a plaster cast is applied.
Prognosis
As a result of damage to the cartilage that occurs with this injury (cartilage is specialised cells that cover the ends of bones where they form a joint), arthritis can develop in later life.
Activity and time off work
As a general rule, six weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.
The Lisfranc joint connects bones in the middle of the foot to those in the front of the foot and is supported by a strong ligament, known as the Lisfranc ligament. This injury is named after Jacques Lisfranc de St Martin, who served in the Napoleonic army in the 1800s. Injuries may result due to a forceful blow, twisting or a crush injury as a result the ligament may tear and or fractures may occur.
Signs and Symptoms
Diagnosis
To confirm the diagnosis x-rays of the foot and or CT/MRI scans maybe required. Occasionally the foot may need to be examined under anaesthesia, to ascertain the degree of disruption.
Treatment
Treatment is dependent upon the fracture pattern, patients’ expectations and overall health.
Non-surgical treatment is used for the lesser injuries and involves a plaster cast for 6 weeks followed by a walking boot for a further 6 weeks.
Surgical treatment is for displaced fractures (where the bones are not aligned). The aim of the surgery is to bring the bones into alignment and stabilise the joints using a metal plate and screws, the skin is then sutured over and a plaster cast is applied.
Prognosis
Even with the correct management the Lisfranc injury patients can have pain and stiffness from the foot. This is because Lisfranc injuries often involve damage to the cartilage (cartilage is specialised cells that cover the ends of bones where they form a joint). As a result arthritis can develop in later life.
Activity and time off work
As a general rule, six weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.
This is a fracture of the heel bone which commonly happens when falling from a height, e.g. from a ladder, roof or an attic. These fractures can also occur due to various conditions such as diabetes or Rheumatoid arthritis.
Signs and Symptoms
Some of the commonly seen signs and symptoms following a calcaneal fracture include:
Diagnosis
The diagnosis is confirmed by obtaining x-rays. If further evaluation is required your surgeon may obtain a CT scan.
Treatment
The treatment for these fractures depends on the pattern of injury, the patients’ general health and their expectations.
Non-surgical treatment often means staying off the affected limb in a plaster or a walking boot, until healing has occurred which is often between 6 and 12 weeks.
Surgical treatment involves making a cut and placing the bones back in the correct place and then stabilising them with a combination of metal plates and screws. The skin is then sutured over.
Whichever form of treatment is chosen, patients are likely to require physiotherapy to help restore function.
Prognosis
Following a calcaneal fracture there can often be stiffness and pain within the back of the foot (hindfoot).
Activity and time off work
As a general rule 6 weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.
The ankle is comprised of three bones: the two lower leg bones (tibia and fibula) and the talus. The three bones are articulated together and supported with a number of strong ligaments. The protrusions from the inner bone (tibia) form the medial/inner malleolus and the outer bone (fibula) forms the lateral/outer malleolus.
The tibia has an outer bump known as the posterior malleolus. Ankle fractures are the most common type of fracture in the lower limb and can vary from a very simple fracture to a complex injury. Simple fractures involve a break to one of the bones, whereas more complex fracture involve breaks in all three bones. These fractures commonly occur due to twisting and rolling.
Signs and Symptoms
Diagnosis
Following an examination X-rays and occasionally a CT scan maybe required.
Treatment
The treatment for each fracture is unique and will depend on the type of fracture, displacement and severity of injury. Non-displaced (where the bones are aligned despite being broken) and stable fractures can be treated in a plaster cast or a walking boot.
When surgery is required, cuts into the skin are made, the bones are re-aligned and held with specially designed metal plates and screws. The skin is then sutured and a plaster is then applied for between 2 and 6 weeks.
Prognosis
Depending on the severity of the ankle fracture the outcomes following treatment vary. Your consultant at the Windsor Foot and Ankle Clinic will discuss this in more detail before and after the operation.
Activity and time off work
Two weeks post surgery is usually required to rest and recuperate. Following this the patient can return to a desk job. Manual jobs may require between 6 – 12 weeks off.
The 5th metatarsal is the long bone on the outer border of the foot that connects to the little toe. The base of this bone is most commonly fractured and there are two types of fracture that can occur depending on the location of the fracture.
The first is an avulsion fracture and is due to the tendon pulling off the bone at the base. The second is known as a Jones fracture and occurs in an area where the blood supply to the bone is poorer. As a result if fractured they take longer to heal. The third type of fracture is a fracture of the shaft of the 5th metatarsal which maybe due to repetitive injuries/stress fracture.
Signs and Symptoms
Diagnosis
After an examination, the diagnosis is usually confirmed through an X-ray.
Treatment
Avulsion fractures can usually be treated without surgery and require a splint. Jones fractures can be treated without surgery in a walking boot, however if the fracture does not heal then surgery maybe required.
Stress fractures are relatively common in the lower limbs, and may affect almost any bone in the foot or leg. There is always an underlying cause, either intrinsic (brittle bones, poor biomechanics) or extrinsic (inappropriate footwear, training regime, running surface etc).
Signs and Symptoms
Non-resolving pain and swelling are usually the main symptoms of a stress fracture.
Treatment
Treatment is tailored to the individual fracture and therefore involves careful assessment of the cause. Usually relative rest or immobilisation is prescribed, but occasionally operative fixation of the fracture is required.
The part of the shin bone (tibia) that forms a joint with the ankle (talus) is known as the tibial plafond or pilon. Fractures in this area occur due to the ankle being forced up against the tibia and are normally as a result of high energy and can include falls from height or motor vehicle accidents.
Signs and Symptoms
Diagnosis
Following a thorough examination to exclude any additional injuries, x rays and often a CT scan are obtained.
Treatment
Initial treatment involves applying a plaster cast and elevating the limb until the swelling has subsided.
Most pilon fractures require surgery. For those that do not, a cast and splint maybe required for a total of 12 weeks. Surgery often involves making cuts to the skin, re-aligning the fractures and holding them in place with metal plates and screws, the skin is then sutured over and a plaster cast is applied.
Prognosis
As a result of damage to the cartilage that occurs with this injury (cartilage is specialised cells that cover the ends of bones where they form a joint), arthritis can develop in later life.
Activity and time off work
As a general rule, six weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.
The Lisfranc joint connects bones in the middle of the foot to those in the front of the foot and is supported by a strong ligament, known as the Lisfranc ligament. This injury is named after Jacques Lisfranc de St Martin, who served in the Napoleonic army in the 1800s. Injuries may result due to a forceful blow, twisting or a crush injury as a result the ligament may tear and or fractures may occur.
Signs and Symptoms
Diagnosis
To confirm the diagnosis x-rays of the foot and or CT/MRI scans maybe required. Occasionally the foot may need to be examined under anaesthesia, to ascertain the degree of disruption.
Treatment
Treatment is dependent upon the fracture pattern, patients’ expectations and overall health.
Non-surgical treatment is used for the lesser injuries and involves a plaster cast for 6 weeks followed by a walking boot for a further 6 weeks.
Surgical treatment is for displaced fractures (where the bones are not aligned). The aim of the surgery is to bring the bones into alignment and stabilise the joints using a metal plate and screws, the skin is then sutured over and a plaster cast is applied.
Prognosis
Even with the correct management the Lisfranc injury patients can have pain and stiffness from the foot. This is because Lisfranc injuries often involve damage to the cartilage (cartilage is specialised cells that cover the ends of bones where they form a joint). As a result arthritis can develop in later life.
Activity and time off work
As a general rule, six weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.
This is a fracture of the heel bone which commonly happens when falling from a height, e.g. from a ladder, roof or an attic. These fractures can also occur due to various conditions such as diabetes or Rheumatoid arthritis.
Signs and Symptoms
Some of the commonly seen signs and symptoms following a calcaneal fracture include:
Diagnosis
The diagnosis is confirmed by obtaining x-rays. If further evaluation is required your surgeon may obtain a CT scan.
Treatment
The treatment for these fractures depends on the pattern of injury, the patients’ general health and their expectations.
Non-surgical treatment often means staying off the affected limb in a plaster or a walking boot, until healing has occurred which is often between 6 and 12 weeks.
Surgical treatment involves making a cut and placing the bones back in the correct place and then stabilising them with a combination of metal plates and screws. The skin is then sutured over.
Whichever form of treatment is chosen, patients are likely to require physiotherapy to help restore function.
Prognosis
Following a calcaneal fracture there can often be stiffness and pain within the back of the foot (hindfoot).
Activity and time off work
As a general rule 6 weeks is required off work for desk jobs and a minimum of 12 weeks for standing or walking jobs. Any labour intensive jobs will require 16 weeks off work.