Foot and ankle fractures can be caused by indirect injuries like twisting or from direct impact injuries caused by slip-and-fall injuries, sports injuries, car accidents or similar accidents. Falling objects can also cause fractures. If a fracture causes a break in the skin, it’s called an open fracture; fractures that don’t pierce the skin are called closed fractures.
A stress fracture is a tiny break in the outer layers of a bone that occurs as a result of repetitive or excessive force or pressure or overuse injuries. People whose feet and ankles are subjected to repeated impacts from running or jumping are prone to these types of fractures. Stress fractures can also occur more frequently in people with osteoporosis, a degenerative condition that causes bones to become porous and weak.
The most common symptom associated with fractures is pain, which can range from mild aching to severe and sharp pain, especially when weight is placed on the foot. Swelling also may occur, and placing pressure directly over the site of the fracture usually causes considerable pain. In severe fractures, the bone or joint may appear deformed. Mobility and range of motion are usually also limited. Some fractures can damage nerves, resulting in numbness and tingling in the foot and radiating into the leg.
Diagnosis of foot and ankle fractures begins with a physical evaluation, including a gentle hands-on assessment and passive and active range-of-motion exercises to pinpoint the source of pain. X-rays or other diagnostic imaging studies will also be ordered to evaluate the extent of the fracture and to guide treatment. Patients will also be asked about the activities that led up to the injury. Once the fracture has been evaluated, treatment options may include casting or splinting for mild to moderate fractures with surgery reserved for severe fractures including those that have damaged the soft tissues surrounding the injury. Pins or screws may be used to hold the bones in their proper positions. When a fracture causes the bones to move out of their normal positions, special techniques may be used to move the bones back into position before the fracture is stabilized, a process known as “reducing” the fracture or, more commonly, “setting” the fracture.