A common misunderstanding I hear in the office is that 'it's just a toe...even if it's broken there is nothing you can do'! The following will help to show how a broken toe really does need proper evaluation and treatment.

Toe and Metatarsal Fractures (Broken toes)

The structure of the foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.

What Is a Fracture?
A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.

Traumatic fractures (also called acute fractures) are caused by a direct blow or impact, such as seriously stubbing your toe. Traumatic fractures can be displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated).

Signs and symptoms of a traumatic fracture include:

You may hear a sound at the time of the break.
“Pinpoint pain” (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
Crooked or abnormal appearance of the toe.
Bruising and swelling the next day.
It is not true that “if you can walk on it, it’s not broken.” Evaluation by a foot and ankle surgeon is always recommended.
Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. They can also be caused by an abnormal foot structure, deformities, or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored. They require proper medical attention to heal correctly.

Symptoms of stress fractures include:

Pain with or after normal activity
Pain that goes away when resting and then returns when standing or during activity
“Pinpoint pain” (pain at the site of the fracture) when touched
Swelling, but no bruising
Consequences of Improper Treatment
Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:

A deformity in the bony architecture which may limit the ability to move the foot or cause difficulty in fitting shoes
Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected
Chronic pain and deformity
Non-union, or failure to heal, can lead to subsequent surgery or chronic pain.
Treatment of Toe Fractures
Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:

Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.
Splinting. The toe may be fitted with a splint to keep it in a fixed position.
Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned.
“Buddy taping” the fractured toe to another toe is sometimes appropriate, but in other cases it may be harmful.
Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.
Treatment of Metatarsal Fractures
Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges.

For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Since the big toe is used so frequently and bears more weight than other toes, arthritis in that area can make it painful to walk, bend, or even stand.

Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone (behind the little toe). It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your foot and ankle surgeon is an expert in correctly identifying these conditions as well as other problems of the foot.

Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include:

Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone.
Avoid the offending activity. Because stress fractures result from repetitive stress, it is important to avoid the activity that led to the fracture. Crutches or a wheelchair are sometimes required to offload weight from the foot to give it time to heal.
Immobilization, casting, or rigid shoe. A stiff-soled shoe or other form of immobilization may be used to protect the fractured bone while it is healing.
Surgery. Some traumatic fractures of the metatarsal bones require surgery, especially if the break is badly displaced.
Follow-up care. Your foot and ankle surgeon will provide instructions for care following surgical or non-surgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return to normal activities

From foothealthfacts.org
Tags: metatarsal, fracture toe, broken toe

Donald Jones was in pain when he sprained his ankle.

Donald Jones' left ankle injury is more serious than originally thought, making it unlikely the Buffalo Bills' receiver will play again this season.

Bills coach Chan Gailey said "it's more long term than short term" when describing the injury Monday, leaving Jones only an "outside chance" of playing again this season. Gailey put the timetable for Jones' absence at three to six weeks after the Bills' 35-8 loss to the Miami Dolphins on Sunday, but with just six weeks left, there's a good chance the Bills will eventually need Jones' roster spot to add depth to another position that's been depleted by injury.
(From Buffalonews.com Nov. 22, 2012)

When one sprains an ankle, it's essential that you rest, ice, compress and elevate the afflicted limb. Next step is to have the ankle evaluated by a trained professional. At Foot Care Centers we perform a thorough exam both clinically and radiographically to determine the appropriate treatment course. Typically, immobilization in ambulatory cast is necessary for two weeks and then transition into an ankle brace thereafter. For athletes, physical therapy is important to regain the strength and proprioception to prevent recurrent sprain and injury.
Tags: sports injury, ankle sprain

QB Matt Schaub out with significant foot injury

Tags: foot injury, lisfranc

Iraq War veteran J.R. Martinez is nursing his right ankle after sustaining a twisting injury during rehearsal on Saturday.  His Dancing with the Stars partner, Karina Smirnoff, stated that the injury took a toll on their subsequent rehearsals.

J.R., the frontrunner in the competition, struggled through his first dance, the Paso Doble, and ended up with a score of 23 out of 30.  He rebounded in the second dance, the Argentine Tango, with a score of 27 out of 30.

It is important to follow the the R.I.C.E. method after a sprain.  Rest. Ice. Compression. Elevation.

If you're still experiencing pain after implementing the R.I.C.E. method, it is important to be evaluated by a foot and ankle specialist.

Tags: R.I.C.E., Twisted Ankle, Ankle Injury, J.R. Martinez, Dancing with the Stars

British rocker Billy Idol was seen at a Beverly Hills medical center on Monday on crutches and with a cast on his right foot.

He underwent foot surgery on 11/2/2011 to "correct malformation of foot due to hitting a truck tire in road a year ago." 

Idol sustained a hair line fracture of one of the bones in his foot.  

Bone healing occurs by developing bone callus at the fracture site.  If the bones are in good alignment and the patient is immobilized in a walking boot or cast, healing will take about 6-8 weeks.  Healing can take longer if the bones shift or if the patient walks to soon.   Surgery is sometimes indicated to realign the bones or correct bones that have healed in a less than ideal position.

rocktrezor.blogspot.com

 

Tags: broken foot, Foot Surgery, Billy Idol

   While playing the Houston Texans last week, Ben Roethlisberger injured his foot.

A scan performed last Monday on Roethlisberger's left foot was negative for a fracture, the sources said. An MRI on Sunday had indicated a possible fracture but the test was inconclusive because of swelling in the foot.

Big Ben was quoted: "If I can do it and if I have to cast it up -- we saw I had to do that last year. I casted up my foot for the last half of the year. If we have to do it, I'll do it."

Foot injuries happen all the time and patients will sometimes 'walk it off' or wait several weeks before having a professional evaluation.  A NFL quarterback has the luxury of physicians available to him 24/7.  However, most of us do not have such a luxury.

If you or a family member have a foot ailment or injury, it is best to have it evaluated and treated as soon as possible to prevent secondary sequelae such as arthritis.  Contact your Podiatrist for treatment.

Tags: injury, Foot Pain, football

A 29 yo California man is the fist person in Kern County to receive a bionic foot.  The Proprio Foot is an artifically intelligent and motor-powered prosthesis.

This prosthesis virtually eliminates limping, compensating, reduces fear of tripping and reduces pain associated with the physical demand placed on the knee, hip and back.

Other models are rigid and have a fixed ankle.  The bionic foot senses motion and is able to adapt to different ground surfaces.

Amputation can result from complications of diabetes, peripheral arterial disease (PAD), traumatic injury and congenital defects.

The bionic foot may be useful for military professionals returning from overseas who have suffered traumatic amputations.

Tags: amputation, below the knee amputation, peripheral arterial diease, diabetes, Proprio Foot, bionic foot

Steelers quarterback Ben Roethlisberger injured his left foot during the 4th quarter of Sunday's game against the Houston Texans.  He finished out the game, but limped off the field and was seen using crutches and wearing a walking boot as he left the stadium.  X rays were taken, followed by an MRI which showed that the foot was not broken.

Roethlisberger sustained a broken bone to the right foot last year and managed to play through the 2nd half of the 2010 season.

One may hear an audible "crack" or "pop" during an injury, followed by swelling, pain and bruising.  Use the "RICE: Rest, Ice, Compression, Elevation" method following any traumatic injury, and be sure to follow up with your foot and ankle specialist.  You will likely need x rays to rule out fracture.  In some cases braces and walking boots may be necessary to properly immobilize your foot. 

Tags: football, foot injury, Roethlisberger

Halle Berry is on location in Spain shooting her new movie "Cloud Atlas."  A little over a week ago, Halle was on the property where she is staying and took a misstep.  She heard a noise and subsequently developed pain.  After evaluation at a local hospital, she was treated for a broken bone in her foot, and was place in a cast.

Broken bones are sometimes treated with cast immobilization alone.  Bone takes about 6-8 weeks to heal.  In some cases, surgical intervention is required.  Screws and plates are used to realign the bone, which speeds up the healing process.

Foot Care Centers' doctors are trained in fracture care and management.  If you or someone you know has sustained an injury and are afraid you may have broken a bone, do not hesitate to call 856-691-2152 to make a preferred appointment.

Tags: Halle Berry, broken foot, cast, broken bone in foot

Now thatSoccer and Football season has officially begun...
Around thirty million adolescents and children participate in organized sports. It is estimated there are three million sports related injuries that require the athlete to miss playing time. In high school age athletes, football has the highest injury rate followed by wrestling. The lowest injury rates are found in gymnastics, basketball, baseball, softball, track and field and cross-country. Injury rates are similar for sports where both males and females participate.

Foot injuries are more common in sports that involve running and kicking. Ankle injuries are common in gymnasts and tennis players.

Tags: Untagged

With the recent end of the N.F.L. lockout, players jumped right back into training camp, many without having completed supervised workouts during the off-season.   This has lead to a considerable rise in injuries. 

There have been reports of at least 10 players with Achilles' tendon tears.  This is a season-ending injury for most.

Sports medicine specialists believe that the number of injuries will taper off as the season continues, and as players achieve improved physical fitness and strength.

For those "weekend warriors" out there, be sure to stretch properly prior to any physical activity (tennis, basketball, softball, flag football or running). 

Simple Achilles stretch:  Place the balls of your feet on the steps leaving your ankles hanging of the steps. Holding onto a railing or putting your hand on a wall as a guide, allow your weight to drop your heels below the level of the stairs.  Hold for 20 seconds. Then slowly raise yourself back up. Repeat this exercise 10 times.  Repeat 3 times a day.

If you or someone you know is suffering from Achilles pain or may have injured the Achilles tendon, please call 856-691-2152 to make a preferred appointment.

Tags: NFL, football, sports, Achilles tendon

While chasing a burglar in his San Fransisco hotel this early this morning, Alex Trebek ruptured his Achilles tendon.

The Achilles tendon connects the calf muscle to the heel bone.  When the calf muscle contracts the tendon pushes the foot downward.

Causes of injury include overuse, trauma, poorly fitting shoes, and certain medications. 

In some cases the patient may be immobilized after rupture, but the best results as far as healing and decreasing the chance of re-rupture are with surgical repair.  Mr. Trebek is scheduled for surgery this Friday.

Tags: Alex Trebek, Achilles tendon, burglar