Foot & Ankle

Fractures

A fracture is a break in a bone. It may be a crack in the bone (a stress fracture) or a complete break; the bones may shift out of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break as well as the patient's overall health.

Digits (toes/phalanges) and metatarsals (long bones of the forefoot) - There are many different kinds of fractures that can happen to the bones of the forefoot and toes. They are painful but often heal without the need for surgery. The metatarsals are prone to stress fractures, or cracks in the bone. These are usually related to a recent increase or change in activity. The fifth metatarsal below the small toe may fracture if it is landed on badly or if the ligament of a twisted ankle pulls off a piece of the bone. Symptoms of a toe or metatarsal fracture include pain that gets worse when walking; swelling; and sometimes bruising.

Lisfranc joint (midfoot) -Often caused by dropping something heavy on the top of the foot or by falling after catching the foot in a hole. Symptoms are similar to a sprain and include swelling and pain at the top of the foot; bruising; possible inability to bear weight; and pain when moving the foot while the ankle is held steady. If you think you have a sprain and it does not improve with rest and ice after one to two days, you may have a Lisfranc joint fracture and should see a doctor to prevent further injury.

Calcaneus (heel) - Usually the result of an automobile accident or fall from a great height. Symptoms include pain on the outside of the ankle or under the heel; inability to bear weight; swelling and stiffness. May be accompanied by back or knee injury due to the amount of force required to break the heel bone.

Ankle - Like severely sprained ankles, broken ankles are often caused by a fall, injury or car accident. Symptoms that one or more of the three bones that make up the ankle may be fractured are: severe pain in the ankle; swelling; bruising; tenderness; inability to bear weight; and deformity of the joint. May be accompanied by dislocation or ligament damage (sprain).

Achilles Tendon Rupture

The Achilles tendon is the strong band of tissue that connects the calf muscle to the heel. If stretched too far, the tendon can tear, or rupture, causing severe pain in the ankle and lower leg that can make it difficult or even impossible to walk. An Achilles tendon rupture, which may be partial or complete, often occurs as a result of repeated stress on the tendon while playing sports such as soccer or basketball. Although frequently resulting from the same stresses that cause Achilles tendonitis, a rupture of the Achilles tendon is a far more serious injury, usually requiring surgical repair.

While inflammation of the Achilles tendon is quite common and may develop gradually, ruptures are usually caused by traumatic injury, frequently accompanied by a popping or snapping sound as the tendon tears. Whether a sports or other injury, a tendon may rupture if it has been previously over-stretched or weakened.

Treatment for an Achilles tendon rupture depends on the severity of the condition, but most often requires surgery to repair the tendon and restore function to the foot. Less severe cases may only require a cast or walking boot for several weeks, although the risk of a recurring rupture is higher with this treatment than with surgical repair. When surgery is necessary, the tendon is reattached and sometimes reinforced with other tendon tissue. Physical rehabilitation for several months is usually necessary after an Achilles tendon rupture, whether or not an operation is performed.