Foot fractures can occur from forceful twisting, falls from a height, crushing injuries, and other severe trauma. The most common fractures are of the toes and metatarsals (35%). Other foot fracture locations include the calcaneus, the navicular bone, the cuboid bone, the cuneiform bones, and the ankle.

Fractures are characterized by focal pain, tenderness, swelling, ecchymosis, and inability to bear weight or ambulate. A fracture can be displaced or nondisplaced. Open fractures and fractures involving vascular damage / ischemia and nerve entrapment / compartment syndrome are extremely urgent presentations requiring immediate consultation with a specialized surgeon. Such injuries may be accompanied by damage to ligaments, other bones, and joints. Stress fractures are microfractures caused by repetitive force or overuse such as marching, running, and dancing, or from excessive weight, poor-fitting shoes, or poor athletic technique or training. Microfractures occur most commonly in the metatarsals.

Management of a foot fracture depends on which bones have been fractured and the severity of the injury. Open fractures pose additional complications from risk of bleeding and infection and involve wound treatment protocols, antibiotic treatment, and tetanus inoculation update. Complications of acute compartment syndrome and vascular damage require immediate surgical consultation, as failure to treat may result in irreversible damage (necrosis) and increased morbidity and mortality. Treatment of pain and inflammation usually involves analgesics (resources for opioid prescribing guidelines, as well as nonopioid alternatives, can be found here), icing, elevation, and immobilization. Displaced fractures and compound fractures may be treated surgically, and a cast applied.

Related topics: fifth metatarsal fracture, lateral talar process fracture, talar body fracture, talar neck fracture, talus fracture