The majority of fractures that occur in the foot can be treated without surgery unless the fracture is significantly displaced and unstable.
The foot is comprised of many bones: the forefoot alone has 29 — five metatarsal bones and 14 phalanges (toe bones). A break in any of these bones can be very painful and make walking a difficult task. An x-ray is used to evaluate the injury and determine the location, type and severity of the fracture. Fractures of the toe (phalangeal bones) are the most likely bones of the foot to fracture. Toe fractures, while painful, often do not need any surgical treatment. Allowing the fracture to heal with rest, ice, elevation and supportive shoes is usually appropriate first-line care for most toe fractures. “Buddy-taping” the fractured toe to a neighboring toe can also help support the fracture while it’s healing. If the fracture is very displaced, your doctor may “reduce” or manipulate the fracture to realign the bone back to its proper anatomic alignment. This can be done under a local anesthetic. Metatarsal fractures are breaks in the long bones found in the middle of the foot. Like toe fractures, surgery is not often required and can be treated with a period of rest, ice, elevation, and supportive shoe wear or a brace. Your doctor will monitor the fracture closely with serial x-rays during your treatment course to ensure proper alignment of the bone is maintained throughout the healing process. However, if there are several metatarsal fractures involved, concurrent ligamentous injury, and the foot is deformed or unstable, an open reduction with internal fixation (ORIF) with plates and/or screws may be necessary to regain proper function and mobility of the foot. This operation is done in a hospital under anesthesia. Your surgeon will identify which bones and ligaments need repair and will then use hardware and strong sutures to ensure that the injury is completely repaired and stable. The foot will be immobilized immediately after surgery in either a splint or a CAM boot. This post-operative protocol requires a period of non-weight bearing on the operative foot, followed by a gradual increase in weight restrictions and physical therapy exercises. Your surgeon and physical therapist will tailor your post-operative course to fit your specific surgery, ability and needs.
Left: Jones fracture; Right: ORIF of Jones fracture with a compression screw
As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free.