Fractures of the Foot & Ankle
General information about fractures of the foot and ankle
The foot and ankle is a common area for injury. Mr Taylor will assess your injury and offer a comprehensive and up to date management plan, including discussing the latest surgical reconstruction techniques and referring you to highly skilled rehabilitation specialists, in order to get injured patients "back on their feet".
What is an ankle fracture?
The bones either side of the ankle joint are called the malleoli. Fractures of the ankle can involve either one or both of these. They commonly occur as a result of twisting injuries to the ankle and there may be associated damage to the soft tissues around the joint, which can lead to a partial or complete dislocation of the ankle joint. Such fracture/dislocations are very serious injuries to the ankle and can take many months to settle down. They can also cause long-term damage to the joint, resulting in arthritis.
How are ankle fractures treated?
Undisplaced fractures - if the fracture is undisplaced, it may be possible to treat this in a plaster cast or walking boot, allowing weight-bearing at an early stage. Check x-rays are taken regularly to ensure the position of the fracture is maintained. These fractures will usually heal within six weeks.
Displaced fractures - if the fracture is displaced, it must be reduced to the correct position and held in place until the fracture has healed. In general, a simple plaster cast in insufficient to hold these fractures and we will therefore often recommend fixation with metal plates and screws. The ankle is usually in a plaster cast for six weeks and you may not be permitted to weight-bear during this period. If both sides of the ankle are fractured, it can take many months for function to return to normal.
Which of the larger bones (the tarsal bones) of the foot are commonly fractured?
The tarsal bones are the bones of the hind and midfoot - the talus, calcaneum, navicular, cuboid and cuneiforms (of which there are three). They tend to be injured as a result of high energy injuries such as falls or road traffic accidents.
Calcaneal fractures - the most common tarsal bone to be broken in the foot is the heel bone (the calcaneum). Injury usually occurs as a result of falling from a height. This damages the joint just below the ankle joint (the subtalar joint). These fractures commonly require surgical intervention to reconstruct this joint, with the aim being to restore the normal shape to the heel and reduce the risk of arthritis in the future. These are major injuries that, regardless of surgery, will often cause long-term disability, requiring further surgery if symptoms persist.
Talus fractures - the talus is the main bone of the ankle joint. Injury to this bone often requires major surgery to reconstruct the ankle joint. A talus fracture is a significant injury that can cause long-term disability. If the blood supply to the bone has been damaged, it may be necessary to fuse the ankle joint in the future.
What is a Lisfranc injury?
This is a high energy injury to the tarsometatarsal joints. It often requires surgery to reduce and stabilise the joints. Recovery can be lengthy and if symptoms persist in the long term, may require fusion of the joints to relieve pain.
How are metatarsal fractures treated?
Metatarsal fractures are common, but often do not require surgical fixation. The majority can be treated with either a plaster cast or removable boot, with weight-bearing at an early stage.
What about toe fractures?
Most fractures of the toes do not require surgery. The toe can simply be strapped to its neighbour (buddy strapping) and comfortable footwear is used for a few weeks while the injury settles. If there is significant displacement of the fracture, we will occasionally recommend surgery with small plates and screws.