On Managing a Broken Foot

Unfortunately a broken foot is relatively common – nearly everyone will break a toe at some stage in their life. They often result from a direct blow, such as dropping something heavy on your toes, or accidentally kicking something hard (usually followed by expletives). This post is intended to assist you in identifying a broken foot or broken toes.

Despite involving such small bones, these fractures can prove impressively painful. Walking is quite a complex movement, with the forefoot working as a functional unit. A fracture of the toe or forefoot will cause pain when you stand, put weight on your foot, or try to walk. Bruising develops, and there is often swelling over the area.

The forefoot has 5 long bones (the metatarsal bones) and 14 phalanges (the toe bones) – 3 phalanges for each toe, save the big toe which only has 2. As with all fractures, the type of fracture dictates the management. Essentially, fractures are either displaced (where the broken ends have been pushed out of alignment) or non-displaced; closed or compound (where the bone has broken through the skin). Compound fractures will need surgery, and displaced fractures need to be re-aligned – sometimes this requires surgery to keep the bones in place.

If you suspect a toe fracture, immediately apply ice, rest and elevate your foot, and apply a soft compressive dressing. Buddy taping the broken toe to its neighbour can help with the pain. Most toe fractures heal well. If the toe looks out of place, or there is a deformity, it may need to be reduced and a visit to your doctor is called for. Otherwise rest until you are able to weight bear comfortably – this usually takes a few days.

The most common bone to be broken is a toe bone; almost everyone will do so at some stage. Find out 15 more random facts about your bones in Bone Trivia – Fun and Facts.

A metatarsal fracture involves the long bone between the toe and the mid foot. Fractures of the metatarsals usually result from a direct blow or a twisting injury. Stress fractures also occur, usually as a result of repetitive, high-impact activities such as running, soccer and basketball, or from a sudden change or increase to your exercise routine.

Most metatarsal fractures heal with an initial period of rest and elevation, followed by limited weight bearing on your foot. Sometimes a cast or a walking boot is needed. Surgery is usually only required if several bones are broken, the foot is deformed, or the fracture is a compound one.

The exception to this is when the fracture is through the fifth metatarsal, the long bone on the outside of the foot. These usually result from an injury which has caused the foot to be rotated downward and inward. If the tendon is overstretched, it may pull away a bone fragment form the base of the metatarsal (toward the middle of the foot), causing an avulsion fracture. This is also called a ballerina fracture, for the damage occurs when the foot assumes en pointe. There is pain over the outside of the foot, followed by significant bruising, as well as difficulty walking. These fractures may need between 6 to 12 weeks in a cast to heal completely, and crutches can be helpful for the first few weeks at least.

A Jones fracture is a type of stress fracture also occurring in the fifth metatarsal. These heal poorly even with complete rest, and usually require surgery.

Most foot fractures usually ‘knit’ within 8 weeks, but it can take several months for healing to be complete. Your foot may remain swollen for a while, requiring looser fitting shoes – never pass up an excuse to buy new shoes! (Though breaking your foot may be a tad extreme way to get a new pair.)