Orthopedics-Online

Broken foot - causes, symptoms, and therapy

introduction

Injuries to the foot or ankle can cause many problems. Anyone who has twisted their foot usually wonders whether it could be a break. Most broken feet are metatarsal because most of the pressure is on the metatarsus.

A metatarsal fracture is a fracture of the middle or toe bones on the foot, which can occur for various reasons. This usually manifests itself in pain when exercising or already at rest.

What are the signs of a broken foot?

Depending on how badly the foot is broken and the foot bones are detached from their original shape, the fracture causes different degrees of discomfort.

Usually a strong swelling or a bruise forms at first. In addition, pain can arise when the affected bones are loaded or when the broken foot is held still.

In the case of severely missing fractures, it can happen that the broken foot can no longer roll over.

Depending on whether the fracture is open or closed, bleeding skin wounds and, in the case of severe misalignment, bone parts can be visible. Abnormal mobility may also be possible.

Broken foot pain

A broken foot can cause a lot of pain. How strong the intensity of the pain really is depends largely on the bone that is broken.

A broken toe can be broken during and shortly after the injury and then no longer cause problems. In most cases one can put full weight on the foot without feeling any pain. However, if another part of the foot is affected, the pain intensity can be significantly higher and make it impossible to step on.

If surgery is needed to heal the bone, or if there is an open fracture with injury to the surrounding soft tissue, the pain can be much more severe and cause problems for longer.

For pain therapy, the attending physician prescribes the necessary painkillers and prescribes physiotherapy in order to enable the treatment to proceed optimally.

Some ankle fractures can also lead to pain in the lower leg, as the excessive force involved in the injury can also break the rear bones of the lower leg. Due to the required immobilization in the foot, particular attention must be paid to pain in the calf, as this can express a deep vein thrombosis, which is often favored by bed rest.

Are you interested in this topic? Then read our next article below: Pain in a metatarsal fracture

Appointment with ?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

How is a broken bone treated?

The therapy depends very much on which bones are broken in the foot and to what extent they have suffered a malalignment.

Simple fractures of individual metatarsals without displacement from the basic structure can usually be treated with a four-week plaster treatment and appropriate immobilization. After that, stress is often possible relatively quickly.

As soon as there is a misalignment that cannot be corrected with a plaster cast, the bone must be brought back into its original position with the help of an operation.

The surgeon uses either screws or so-called Kirchner wires to help. The process is also called screw fixation.

Often no large, open surgery is required, but small skin incisions made from the outside are sufficient. After the operation, a plaster splint and relief with crutches are usually still required.

The screws or wires used usually remain in the foot for life and usually do not cause any problems. Severe, open bone fractures with severe swelling must swell before the treatment so that the pressure does not increase within a cast.

So that the foot bones are not further misaligned during the swelling of the soft tissue, the bones are held in a fixed position with a so-called "external fixator". In addition, prophylactic antibiotic treatment prevents bacterial infections.

If you are further interested in this topic, then read our next article below: Therapy of a broken bone

How long do you need a cast?

If the foot is broken, it must first be immobilized and stabilized with a cast or splint. How long you need a cast in order to allow the fracture in the foot to heal completely depends on the type and location of the injury.

If one of the toes is broken, a so-called roof tile bandage is usually applied, which makes movement in the joint impossible and, in different variants, allows neighboring toes to give each other stability. Usually 3-4 weeks are completely sufficient for this bandage.

With a fracture in the forefoot or metatarsus, in most cases a cast shoe has to be worn for 6 weeks. This ensures that the foot itself is stabilized and stiff. The ankle should still be mobile.

If the heel and ankle are affected by the fracture, the lower leg may also have to be cast in a cast. Here, too, it is necessary to immobilize the ankle for at least 6 weeks.

You can find out more about this topic in our next article at: Plaster of paris

Which doctor should I see?

Ideally, an orthopedic surgeon or trauma surgeon should be consulted on the day of the accident so that detailed diagnostics and imaging procedures can determine whether and where there is a fracture or whether, for example, only the ligaments or soft tissues are affected.

If the foot is actually broken, the severity of the fracture must be determined. The doctor will first find out in a conversation what kind of illness is to be expected. The localization of the pain and the course of the accident provide important information.

Then he will determine which parts of the foot are affected with the help of a physical examination and, if necessary, X-rays, CT or MRI. After all, what therapy method is used to treat the injury and what kind of protection should be observed depends on his diagnosis.

Duration of treatment

In general, the healing time for a broken foot depends on various factors. In younger patients who are still in the growth phase, fractures heal much faster and with fewer complications than in older patients.

The bone tissue is temporarily replaced by a tissue called "callus tissue". This stabilizes the broken area and grows much faster in younger patients than in older people. The soft tissue destroyed by the fracture and the degree to which the bones are displaced from their original position also play a role.

The healing process can be shortened by an operation, since the corresponding bone parts are held together in the desired position by screws or wires.

Prognosis for a broken bone in the foot

The entire healing process after the foot is broken usually takes 6-12 months to complete. In most cases, however, a symptom-free state can be achieved after 6 weeks, in which the patient can exercise reasonably normally.

Regardless of whether the fracture was treated with an operation or with a cast alone, a doctor's visit is advisable after 6 weeks. It can be checked whether the broken bone parts have been put together correctly and are correctly aligned again and to what extent the injury has already healed. In addition, discomforting wires or screws can be removed.

Causes of a broken foot

If the foot is broken, different causes can come into question. The most common cause is sport. The metatarsal fracture is one of the most common fractures experienced by athletes, whether while jogging or falling when suddenly incorrect movements are made.

Strong, direct violence, for example through an accident, can also cause a metatarsal fracture. Unexpected bumps in the floor can lead to ankle twisting of the foot (Supination trauma) to the outside and thus, in addition to the more frequent injuries to the ligamentous apparatus, also damage to the metatarsal bones.

Another cause of the metatarsal fracture can be a fatigue / stress fracture. Long-term incorrect or unfamiliar loads lead to overloading of the middle bones. Osteoporosis is a risk factor for such a fracture.

The patients can (unlike the fractures caused by trauma) usually do not remind you of a direct accident, but rather slowly feel pain after prolonged exertion or at a later stage even when standing.

Another special fracture is the fracture of the fifth metatarsal. Here, the foot on the metatarsal bone is broken from the little toe. The tendon of a long lower leg muscle attaches to this bone. As a result of excessive tension in the muscle due to an outward buckling, the tendon can tear and the foot may break at this point.

Which complications can arise?

A rare but dangerous complication that can occur when the foot is broken is what is known as a “compartment syndrome”.

In the process, very heavy bleeding into a space closed by a muscle fascia leads to an increase in pressure in the corresponding compartment, whereby the supplying nerves and arteries are squeezed and the foot is insufficiently supplied. This manifests itself in an uncomfortable feeling of pressure in the foot and a feeling of numbness.

Such a compartment syndrome requires immediate therapeutic measures. After a pressure measurement in the relevant compartment, it may be necessary to open the muscle fascia directly so that the pressure can escape.

If the foot is insufficiently supplied for too long, the tissue can die, which should be prevented by the pressure relief.

Read more on this topic under: Compartment Syndrome

Is it a metatarsal fracture or just bruised?

After direct but blunt force impact on the bones of the foot, a bruise can occur in addition to a broken bone (Contusion), which initially manifests itself with symptoms similar to a broken foot.

In contrast to the situation when the foot is broken, a bruise only affects the soft tissue and the bones are not damaged. Bleeding into the muscle causes the skin to turn blue over the area affected by force, the tissue swells and feels overheated.

Similar to if the foot is actually broken, severe pain occurs when exercising, so that movement can also be restricted.
Most of the time, however, the symptoms regress on their own after some time, with extended protection of the affected areas and bruises usually run without complications.

With very strong force or damage to a large artery, which empties into a space closed by a muscle fascia, so that the pressure rises sharply, the already mentioned complication of the compartment syndrome can also occur.Supplying vessels and nerves are pinched off and the tissue can no longer be adequately supplied.

Tissue destruction and death can occur if the pressure is not released quickly enough.

The affected person can follow the "PECH" rule, which also applies to sprains, in order to promote the healing of the bruise:

P - First of all, it is important to take a break with immobilization of the affected body part.

E - Also helps to reduce the swelling by cooling the area (ice)

C - and a firm pressure bandage (compression) often helps to achieve stability.

H - Elevation counteracts the swelling and relieves the affected area, so that there is less pain.

Metatarsal fracture prophylaxis

Preventing the foot from breaking is usually difficult because it is mostly an unpredictable accident mechanism.

However, by taking special care in certain sports or by wearing appropriate protective clothing, a worse accident can be prevented.

The right footwear with sturdy soles can also be decisive for stability during a fall.

Anatomy digression

The metatarsus consists of five metatarsal bones, which in a row form the connection between the tarsal bones (Wedges and cubes) and form the terminal bone of the toes. They are connected to each other by strong ligaments and are also held together by the tendons of the lower leg muscles.

Together with the toe bones, they are called the "forefoot". The metatarsal bones can move against each other and allow the foot to roll and adapt to bumps on the ground while running.

Read more on the topic: Tarsus fracture