Broken Foot

Next Steps

Follow-up

Follow-up with your doctor or orthopedist often is needed to make sure that foot fractures are healing well. Follow-up is particularly important if pain continues or if you have difficulty walking.

Prevention

It is always better to prevent broken bones than to treat them.

• Construction workers and others at risk for foot injuries should always wear steel-toed protective boots.

• Sports always should be performed with well-fitting supportive athletic shoes.

• When riding in a car, do not allow passengers to dangle feet out the window or place feet up on the dashboard.

• Always wear a seatbelt when riding in a car.

Outlook

Toe fractures are common and generally heal well with little or no therapy. Although the bones may take 3-8 weeks to heal, pain usually improves much earlier. Rarely, very severe fractures, especially of the big toe, may require a cast or surgery.

• Metatarsal fractures usually heal well. The first metatarsal (the one attached to the big toe) sometimes requires a cast or surgery and a prolonged period on crutches, but the middle 3 metatarsals can usually be treated with a rigid flat-bottom shoe and partial weight bearing. "March fracture" is a metatarsal stress fracture that commonly occurs in joggers and requires stopping jogging for 4-6 weeks.
  
  
• The fifth metatarsal (the one attached to the pinkie toe) is the most commonly broken bone in the midfoot. There are 2 general types.
  
  
  • One type is the proximal avulsion fracture. These are very common and usually happen at the same time as a sprained ankle. They heal very well with a rigid flat-bottom shoe or elastic bandage and weight bearing as tolerated.
    
    
  • The other type is the Jones fracture, which is much less common but does not heal as well. This fracture gets worse with time if you keep walking on it, so non-weight bearing is very important. People with this fracture often (35-50% of the time) develop problems healing that require an operation.
  
  
• Fractures at the joint between the cuneiforms and the metatarsals are called Lisfranc fractures. These are rare, but can be difficult to diagnose and treat. Weight-bearing x-rays (taken while standing on the injured foot) are sometimes needed to look for this problem. These fractures sometimes require surgery.
  
  
• Navicular fractures are rare and most often represent stress fractures in young athletes. They usually heal well with a rigid flat-bottom shoe and weight bearing as tolerated. Severe fractures through navicular bone sometimes require surgery.
  
  
• Calcaneal fractures often occur in people who fall from a height and land on their feet. These people often have other injuries as well, so they should be examined carefully. The most common fracture of the calcaneus, the intraarticular joint depression fracture, usually requires surgery. Other fractures of the calcaneus can usually be treated with splints or casts and non-weight bearing.
  
  
• There are many types of Talar fractures, some of which are difficult to diagnose and treat. Lateral process fractures often occur from snowboarding injuries. Posterior process (Shepherd) fractures are found in athletes who dance or kick. The diagnosis of these injuries often cannot be made in the doctor's office or emergency department on the initial visit and require bone scans or other studies if symptoms continue. Treatments vary but often require splints or casts and a period of non-weight bearing.