Broken foot

Overview

A broken foot, also called a fractured foot, is an injury to one or more bones in the foot. A bone might break from a sports injury, a car crash, a heavy object dropped on the foot, or a misstep or fall.

Fractures can range from tiny cracks in the bones to breaks in more than one bone and breaks that come through the skin.

Treatment for a broken foot bone depends on where the bone breaks and how bad the break is. A badly broken foot bone may need surgery to put plates, rods or screws into the broken bone pieces to hold them in place while they heal.

Symptoms

A broken foot bone might cause some of these symptoms:

• Instant throbbing pain.
• Pain that gets worse with activity and gets better with rest.
• Swelling.
• Bruising.
• Tenderness.
• Change in the typical shape of the foot, called deformity.
• Trouble or pain with walking or putting weight on the foot.
• Bone sticking through the skin, called an open fracture.

When to see a doctor

See a healthcare professional if your foot has lost its shape, if the pain and swelling don't get better with self-care, or if the pain and swelling get worse over time. It's possible to walk on some fractures, so don't assume you don't need medical care if you can put weight on your foot.

Causes

The most common causes of a broken foot include:

• Car accidents. The crushing injuries that can happen in car accidents may cause breaks that need surgery to be fixed.
• Falls. Tripping and falling can break bones in the feet. So can landing on the feet after jumping down from a height.
• Impact from a heavy weight. Dropping something heavy on the foot is a common cause of fractures.
• Missteps. Sometimes a stumble can result in a twisting injury that can cause a broken bone. A toe can break from stubbing it on furniture.
• Overuse. Stress fractures are common in the weight-bearing bones of the feet. Repeated force or overuse over time, such as running long distances, most often is the cause of these tiny cracks. But they also can happen with regular use of a bone that's been weakened by a condition such as osteoporosis.

Risk factors

You may be at higher risk of a broken foot or ankle if you:

• Play high-impact sports. The stresses, direct blows and twisting injuries that happen in sports such as basketball, football, gymnastics, tennis and soccer can cause foot bone breaks.
• Use poor technique or sports equipment. Poor training techniques, such as not warming up, can raise the risk of foot injuries. Bad equipment, such as shoes that are too worn or don't fit right, also can increase the risk of stress fractures and falls.
• Suddenly increase your activity level. Whether you're a trained athlete or someone who's just started exercising, suddenly boosting how long, hard or often you exercise can increase your risk of a stress fracture.
• Work in certain jobs. Certain workplaces, such as construction sites, put you at risk of falling from a height or dropping something heavy on your foot.
• Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and foot injuries.
• Have certain conditions. Having decreased bone density, called osteoporosis, can put you at risk of injuries to your foot bones.
• Smoking. Cigarette smoking can increase the risk of getting osteoporosis. Studies also show that healing after a break may take longer in people who smoke.

Complications

Complications of a broken foot bone aren't common but may include:

• Arthritis. Fractures that extend into a joint can cause arthritis years later. If your foot starts to hurt long after a break, see your healthcare professional.
• Bone infection, called osteomyelitis. If you have an open fracture in which one end of the bone pokes through the skin, your bone may be exposed to bacteria that cause infection.
• Nerve or blood vessel damage. Trauma to the foot can injure or tear nerves and blood vessels. Seek medical help right away if you notice numbness or feel like your foot isn't getting enough blood. Lack of blood flow can cause a bone to die, called avascular necrosis.
• Compartment syndrome. This condition rarely occurs with foot fractures. It causes pain, swelling, numbness and sometimes being unable to use the affected muscles of the foot.

Prevention

These sports and safety tips may help prevent a broken foot bone:

• Wear proper shoes. Use hiking shoes on rough terrain. Choose the right athletic shoes for your sport.
• Replace athletic shoes when needed. Get rid of shoes as soon as the tread or heel wears out or if the wear on the shoes isn't even. If you're a runner, replace your shoes every 300 to 400 miles.
• Start slowly. That applies to a new fitness program and to every workout you do.
• Have a balanced fitness program. A balanced fitness program includes aerobic fitness to work your heart, strength training to build muscles and movements that put your joints through their full range of motion, called flexibility.
• Build bone strength. Get enough calcium and vitamin D. Calcium-rich foods include dairy products, leafy greens and tofu. Ask your healthcare professional if you need to take vitamin D supplements.
• Use night lights. Many broken toes are the result of walking in the dark.
• Get rid of clutter in your home. Keeping clutter off the floor can help you not trip and fall.

Diagnosis

Your healthcare professional will look at your ankle, foot and lower leg and check for tenderness. Moving your foot around can show your range of motion. Your health professional might want to watch how you walk.

Imaging tests

To diagnose a broken foot, your healthcare professional might order one or more of these imaging tests.

• X-rays. Most foot fractures can be seen on X-rays. Stress fractures often don't show up on X-rays until the break starts healing.
• Bone scan. A bone scan can find breaks that don't show up on X-rays. A technician injects a small amount of radioactive material into a vein. The radioactive material makes damaged bones, including stress fractures, show up as bright spots on the image.
• CT scan. A CT scan uses X-ray techniques to create detailed images of the bones in the body from different angles. Compared with X-rays, CT scans can show more detail about the injured bone and the soft tissues that surround it.
• MRI scan. MRI uses radio waves and a strong magnetic field to create detailed images of the soft tissues in the foot and ankle. This imaging can show breaks not seen on X-rays.

Treatment

Treatments for a broken foot vary depending on which bone is broken and how bad the injury is.

Medications

Your healthcare professional may suggest a pain reliever available without a prescription, such as acetaminophen (Tylenol, others).

Therapy

After your bone heals, you need to restore the motion and strength of your foot and ankle. A physical therapist can teach you exercises to help you restore full motion and build strength.

Surgical and other procedures

• Reduction. If you have a displaced fracture, meaning the two ends of the fracture are not aligned, your healthcare professional may need to move the pieces back into place. This process is called reduction. You may need medicine to relax your muscles, calm you or numb the area before this procedure.

• Immobilization. Most often, a broken bone must be kept from moving so that it can heal. This is called immobilization. Most often, a cast holds the foot in place.

  Minor foot fractures may need only a brace you can take off, or a boot or shoe with a stiff sole. A broken toe can be taped to the next toe, with a piece of gauze between them, to keep the broken toe still.

• Surgery. In some cases, a surgeon who specializes in bones and joints, called an orthopedic surgeon, may use pins, plates or screws to keep a bone in place while it heals. These materials may be removed after the break has healed or if they stick out of the skin or cause pain.

Preparing for an appointment

You will likely seek treatment for a broken foot bone in an emergency room or urgent care clinic. If the pieces of broken bone aren't lined up for healing, you may be referred to a doctor specializing in orthopedic surgery.

Treatment

What you can do

You may want to write a list that includes:

• Your symptoms and how they began.
• Other medical conditions you have.
• All the medicines, vitamins and supplements you take, including doses.
• Questions to ask the healthcare professional.

For a broken foot, basic questions to ask include:

• What tests do I need?
• What treatments are there? Which do you suggest?
• If I need a cast, how long will I need to wear it?
• Will I need surgery?
• How much will I need to limit my activities?
• Should I see a specialist?
• What pain medicines do you suggest?

Be sure to ask all the questions you have.

What to expect from your doctor

Your healthcare professional may ask questions, including:

• How did you injure yourself?
• Did your symptoms come on suddenly?
• Have you injured your feet in the past?
• Have you recently begun an exercise program or started exercising more or harder?

Preparing for an appointment

What to do in the meantime

If your injury isn't bad enough for you to go to an emergency room, here are some things you can do at home until you can see your healthcare professional:

• Apply ice for 15 to 20 minutes at a time, every 3 to 4 hours, to lessen the swelling.
• Keep your foot and ankle raised above the level of your heart to limit swelling.
• Don't put weight on your injured foot.
• Lightly wrap the injury in a soft bandage that provides slight pressure.