Them’s the breaks: How I treat foot fractures
As a practicing podiatrist for over 20 years, I have spoken with patients that did not know that podiatrists treat fractures. It’s a common refrain as they generally feel that only orthopedists handle fractures. While I can’t speak for everyone, I can say that I have been managing foot fractures for years. Most foot fractures require protective weight bearing with either a surgical shoe or a walking boot. Fractures generally require four to six weeks of offloading to heal. On the rare occasion surgery is needed. This percentage is small.
The foot has 28 bones that work in harmony and keep us upright. Icy conditions, athletics and everyday wear and tear take its toll. It amazes me that more problems don’t arise. I have managed fractures in all of them over my career. Most often toe fractures are the culprit. These are generally manageable and not much can be done for them. I recommend buddy taping and surgical shoe treatment. After a short period of time patients abandon this treatment and deal with the discomfort.
The next subset of fractures are metatarsal fractures. These generally get treated with a surgical shoe or a walking boot. The worst of these are called Jones fractures which occur in the base of the fifth metatarsal. The area that breaks has poor blood supply and requires longer term offloading or maybe surgery. Metatarsals will also be impacted with stress fractures. Stress fractures occur when the bones get overused. The second metatarsal is a common bone to see this occur. The treatment is offloading in a boot or surgical shoe for six to eight weeks as well.
The next subset of bones is called the tarsal bones which are in the hindfoot. These usually are caused by higher velocity injuries such as calcaneal fractures and talar fractures. Less likely to occur are cuneiform, cuboid or navicular fractures. They usually be caused by a fall from a height. Depending on the alignment the treatment is the same as the other injuries.
As the weather warms and patients become more active, I recommend if something does not feel right make an appointment. Fractures are treatable and the longer one waits the harder they are to treat. If you notice swelling and bruising after a foot trauma, I recommend calling the office and being evaluated as soon as possible.
David Weiss, DPM, is the owner of Weiss Foot & Ankle Center located at 777 South White Horse Pike, Suite D1 in Hammonton. For more information or to make an appointment, call (609) 561-2488 or visit weissfootandankle.com.