Foot and Ankle Fractures

The ankle joint includes three bones, while the foot has 26 different bones, all of which can fracture from accidents, injuries, and overuse. Foot and ankle specialists are trained to evaluate symptoms, diagnose problems, and provide both non-surgical and surgical treatment options.

North Carolina Specialty Hospital foot and ankle orthopedists offer expert care for all types of fractures. Our surgeons are leaders in their field and can provide technologically advanced surgical procedures when conservative treatments are inadequate.

Types of Foot and Ankle Fractures

The many different bones of the foot and ankle joint can fracture due to repetitive use, sports injuries, and physical trauma.

• Impact Fracture. An impact fracture is an acute injury that occurs when a force is applied to the bone, causing it to break. Potential causes include rolling the ankle, dropping an object on the foot, or an impact due to a car accident. A closed fracture occurs when there is no break in the skin. An open fracture is when the skin is broken and the wound goes to the bone. The fracture is displaced if there is a separation between the two broken parts.
• Stress Fracture. Stress fractures occur over time rather than suddenly. They are small breaks or cracks. A stress fracture in the ankle or foot usually results from repetitive motion and overuse. Changing physical activity level or type—for instance, increasing running mileage or intensity too quickly—is a risk factor for stress fractures. Osteoporosis is also a risk factor.
• Toe and Metatarsal Fractures. Both overuse and sudden impact commonly cause fractures in the toes and in the metatarsals, the bones in the forefoot. These fractures rarely require surgery to correct.
• Ankle Fractures. A broken ankle may involve a single fracture in one bone or multiple fractures. Breaks may occur at the end of the tibia or fibula, bones of the leg, or in the talus, which sits between the leg bones and the heel bone. Complicated fractures that lead to ankle instability often require surgical treatment.
• Heel Fracture. The heel bone (calcaneus) is the second most common location for stress fractures in the foot. The pain it causes is similar to plantar fasciitis, an injury to connective tissue. Surgery is usually only needed if the fracture is displaced.
• Navicular Fracture. A fracture in this bone, which is in the middle of the foot, causes pain that can be hard to pinpoint. It is uncommon but not impossible to have a stress fracture here, and it often requires surgery to stabilize.

Treatment for Foot and Ankle Fractures

In many cases, fractures of the foot and ankle bones do not require surgical treatment. If the fracture is minor or simple, treatment usually involves rest, ice, compression, and elevation followed by modified activity while the fracture heals. Some patients benefit from a cast or protective footwear to stabilize the fracture and prevent movement.

Some patients need surgery if the fracture is complicated or displaced or if the foot and ankle are unstable. If you tried conservative measures but the break isn’t healing correctly, you might need surgery.

If you have a displaced foot or ankle fracture, surgery may include fixation. This means the surgeon uses screws, plates, wire, or other surgical devices to fix and stabilize the broken bones.

Closed Reduction vs. Open Reduction Fracture Treatment

Surgery is not always necessary for a displaced fracture. In some cases, the orthopedist can set the bones through a method called closed reduction. They physically manipulate the bones without performing surgery.

An open reduction internal fixation ankle fracture is severe enough that the orthopedist must make a cut to get to the bones and fix them in the correct position. A closed reduction might be preferable to reduce the risk of infections and other surgical complications.

Recovery from Ankle Surgery

A stress fracture typically takes six to eight weeks to heal. A more complicated fracture, especially one that required surgery, may take longer. Rest and activity modification are essential for quicker healing and return to normal activities. Follow your orthopedist’s instructions about what you can and cannot do until the fracture heals.

You may need to wear a boot or use walking supports if full weight-bearing activity isn’t possible. Your doctor will probably also recommend physical therapy and rehabilitation to help you gradually and safely return to activities. They might also order additional imaging tests to assess the progress.

In North Carolina, the foot and ankle specialists at NCSH offer multiple locations for expert evaluation, diagnostics, treatment, and recovery. Request an appointment with an orthopedic surgeon to talk to an expert about your foot and ankle pain.