Do broken bones in the foot always require surgery?
We ask a lot of our bodies and, more often than not, take for granted that the demands we make on them will simply be done. Usually, this happens automatically, without even a pause on our part to think about how all of the various parts work together. That can change in an instant, however, when we twist an ankle or drop something heavy on a foot and, all of a sudden, every step we take comes with shooting pain.
The foot is susceptible to a wide range of injuries. These include sprains involving the ligaments that hold the joints together, strains of the various tendons and muscles that allow the foot to move and breaks or fractures in the bones. By the time we reach adulthood, the number of bones in the human body is around 206, and each foot contains 26 of that total. That, coupled with how much weight the foot is asked to bear and all of the stress we place on it, may help explain why foot fractures are one of the most common reasons that send people to see their doctors.
There are three main parts to the foot:
- Forefoot: made up of the toes and the metatarsals which are the bones that connect to the toes
- Midfoot: contains the tarsal bones that form the arch of the foot and connects the toes to the heel
- Hindfoot: this is the heel bone (calcaneus) and the joints that link to the talus bone of the ankle
Falls, car accidents, trauma and repetitive stress from sports or other recreational or occupational activities can result in one or more fractures in the foot. Sometimes these injuries are relatively minor, which is often referred to as stress or “hairline” fractures. If the break is allowed to heal without further injury from continued stress, treatment at home may be all that is necessary. This would typically consist of the R.I.C.E. protocol of rest, ice, compression and elevation.
A hairline fracture can take up to 8 weeks to completely heal. During that time, it is important to avoid re-injury and to seek medical attention if the pain gets worse or does not begin to subside.
Displaced or Undisplaced Fractures
Treatment for more serious breaks in the bones of the foot depends a lot upon whether they are displaced or undisplaced.
When a bone breaks into two or more pieces and is completely out of alignment, this is referred to as a displaced fracture. With this type of injury, the ends of the bone may even break through the skin.
In an undisplaced or non-displaced fracture, the bone may be cracked or broken all the way through but the pieces remain in their original position and in correct alignment.
Your orthopedic surgeon will recommend treatment based upon the severity of the break and whether it requires surgery to repair and realign the bones. Undisplaced fractures often require no more than bracing with a boot or wearing a cast, combined with pain and anti-inflammatory medications, as well as keeping pressure off of the affected foot. Some undisplaced fractures will also benefit from nonsurgical realignment.
For the more serious displaced fractures, surgery will be recommended to realign the bone. Every break is different and will require a unique combination of screws and metal plates to ensure that the bone does not move out of alignment during the healing process.
Recovery time following surgery to fix a fracture in the foot will typically take 6 to 8 weeks. Physical therapy may be recommended.
If you have questions about a foot fracture or about any foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC. To schedule an appointment, or if you just have questions, please use our convenient online contact form by clicking here.