Caring for foot and ankle trauma

Common injuries

Broken or fractured toes are the most common type of foot injury, followed by cracks or breaks in the metatarsal bones, which are the long bones in the foot.

If a foot or ankle injury causes the bones to bend or move out of their normal place, see a doctor. A doctor can also decide if you need surgical reduction, which sets bones back into place.

There are many types of foot and ankle injuries. Depending on where the broken bone is in the foot, care could involve: 

• Wearing a weight-bearing cast boot
• Changing non-weight bearing activity
• Having surgery
  

Getting specialized foot and ankle care

Diagnosis is how a doctor finds out what medical problem you have. A common missed diagnosis in foot and ankle trauma is a Lisfranc ligament.

With a Lisfranc ligament rupture injury, there can be: 

• Tenderness at the top of the foot between the first and second metatarsal base
• Pain with stress of the midfoot joints in any direction
• A lot of swelling and bruising at the dorsal midfoot

Often, ruptured Lisfranc ligaments are cared for with surgery. Most healthy patients have surgery done as soon as possible after the injury.

This injury can have painful, long-term side effects if not cared for correctly. This includes post-traumatic osteoarthritis, which causes swelling in the joints.

First metatarsal fractures and multiple metatarsal fractures should always be looked at by a foot and ankle surgeon. Midfoot stability may be problem also. 

Achilles tendon ruptures

The Achilles tendon connects the calf muscles and heel. Achilles tendon ruptures are rarely missed. People with these injuries usually have a lot of pain. These kinds of injuries may happen in older, less physically active people. 

Sometimes these injuries happen when someone is simply walking around their home. Other times, they happen because the tendon is worn out or because of taking a certain type of antibiotic.

People with this injury may describe feeling a sudden sense of weakness or difficulty walking. Doctors may use physical exam, ultrasound or MRI to help figure out if this is the kind of injury you may have. 

Ultrasound uses sound waves to form pictures of the inside of the body. MRI is a scan that uses magnets and radio waves to get pictures of the head, spine, joints and other parts of the body.

Care for ankle sprains

There are many kinds of ankle sprains. Your doctor will tell you what to do for your injury, which may include:

• If there is a lot of swelling, use cast-boot immobilization for at least two weeks.
• While sleeping, a cast boot or a night splint are good ideas.
• If there’s not much swelling and you’re able to bear weight, bracing and physical therapy may be appropriate.
  

Follow-up treatment

If the swelling improves and you’re able to bear weight comfortably, you can change to bracing and physical therapy. 

Keep wearing the night splint for two weeks if:

• Your swelling and pain are not improving
• You have a feeling of weakness in the foot and ankle

Stopping long-term problems

If your ligaments don't fully heal, long-term instability and pain could result. If your foot or ankle injury isn’t healing well, your doctor may tell you to have a stress X-ray or MRI.   

X-rays can create a picture of the inside of the body in different shades of black and white.

Your doctor may tell you to try other types of care, such as:

• Injections
• Arthroscopy (a type of surgery)
• Ligament repair

Make an appointment

If you have questions about ankle and foot injuries, call our podiatry department at 1-206-860-4457. Podiatry is a field of medicine that focuses on the medical and surgical treatment of the feet and ankles.

By Sarah Burns DPM, FACFAS and Daniel Lowinger DPM, FACFAS

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.