Broken Foot - Causes, Symptoms, Diagnosis, and Management

Introduction:

The foot and ankle fractures due to trauma is a medical emergency that must be treated immediately. Though it is not fatal, it can still affect normal functioning and cause impairment and dysfunction. Hence, it is essential to restore the structure and function with rehabilitation.

The bones forming the foot support the foot muscles and tissues, providing mechanical support for the body to withstand, wait, walk, move, and perform all the actions of locomotion. The bones forming the foot can be divided into three compartments which the bones present are:

• Hindfoot:

  • Talus.

  • Calcaneus.

• Midfoot:

  • Navicular.

  • Cuboid.

  • Cuneiform.

• Forefoot:

  • Metatarsals.

  • Phalanges.

What Are the Type of Fractures?

A fracture of a bone is usually a crack or break in the bone, which requires immediate medical attention. The fractures are classified as follows:

• Displaced - It is a fracture where the fractured segment is displaced from its original position.

• Non- Displaced- It is the type of fracture when the broken segment remains within the initial position.

• Open - The fracture is displaced and pictures the soft tissues making it visible outside.

• Closed- The bone is broken and displaced, but the skin over the surface is seen as untouched.

What Is a Broken Foot?

A broken foot is a clinical condition occurring due to a fracture of the bones forming the foot. It is usually seen by a dislocated or swollen foot or ankle and is often confused with a sprain, and it is essential to differentiate it.

What Causes a Broken Foot?

A broken foot is a very commonly occurring condition seen in children and adults. It occurs predominantly in males; the reasons are usually trauma stress or strain. The common causes are:

• Vehicle accidents.

• Fall injury.

• High-impact sports like soccer, football, and basketball.

• A sudden increase in activities like exercises and treadmills.

• Health conditions with low bone density.

• Smoking (as it also causes low bone density).

• High strained work like the armed forces.

• Due to a twist or sprain of the ankle.

• Due to physical abuse (seen commonly in children).

How Is It Seen Clinically?

This condition is clinically seen showing the following symptoms:

• Throbbing pain.

• Swelling.

• Limping.

• Purplish black bruises at the site of injury.

• When the foot feels numb after an injury.

• When the foot is sensitive or tender on touch.

• When the foot appears to be deformed or dislocated.

• When there is difficulty in walking or bearing weight.

What Are the Types of Foot Fractures?

The fracture of the foot is divided into three based on the location. Based on their site, they are fractures of the front, mid and hind foot.

What Are the Risk Factors Causing Broken Foot?

The reasons which can result in a broken foot are:

• Sports requiring high impact.

• Improper usage of sports equipment or at the gym.

• Jobs requiring high-intensity work.

• Inconsistent or sudden workouts.

• Systemic conditions like weaker bones or low calcium density.

What Are the Methods Used for Diagnosing Fractures?

• Clinic Diagnosis: The first line of diagnosis is done clinically by the doctor. The foot is examined for any bruises or dislocations. It is then palpated to find any swelling or any signs of inflammation.

• Radiographs (X Rays): X-rays are used for investigating a broken foot. They are used as a confirmatory investigation. They are used to detect the fracture line's presence and analyze the fracture's type and degree of dislocation.

How Is Broken Foot Treated?

Two methods; non-surgical and surgical, can treat a broken foot.

1) Non-surgical Management: When given some time, a broken foot, rest, immobilization, and painkillers tend to heal themselves. The first line of treatment is called RICE, meaning rest, ice pack, compression, and elevation.

• Rest: The patient is put on complete rest to take the weight off the foot. Bearing stress or weight on foot is only going to worsen the condition.

• Ice Packs: They are used over the injury at a break of 20 minutes for 48 hours. This reduces the inflammation happening soon after the surgery.

• Compression: Compression is provided by gauze or soft bandages wound around the foot, giving compression. This is used to help the regularization of blood flow and reduce swelling.

• Elevation: The foot is kept in an elevated position to maintain the blood flow and also to reduce or prevent excessive swelling.

2) Surgical Management: The broken foot is treated surgically when there is any dislocation of the foot, visible open fracture, or fracture line in the X-ray. The surgical treatment is done by:

• Reduction: The dislocated bone fragment with displacement is repositioned and placed in the original position.

• Fixation: The relocated fractured bone which was displaced is fixed in the same position using splints, plates, metal pins, and screws. It is called internal fixation of a fracture. Braces and splints externally fix the fracture.

• Immobilization: The fracture is immobilized using plaster or bandages in the same fixed position. They help the foot be held in the same place.

• Rehabilitative Management: Healing of a fractured segment takes almost six to 12 weeks to heal, but in the case of a foot fracture, it is essential not to put the workload on the foot or redirect the weight load. This is enabled by using walking aids like sticks or crutches, which ease the movement of the patient. Physical exercises slowly train the patients to strengthen and perform actions like flexion and extension of foot.

What Are the Complications Due to Broken Foot?

Few complications occur along the fractured foot. They appear as an adverse reaction to the condition. Those complications are:

• Nerve Damage: Foot trauma can also damage the nerve or blood vessels by puncturing the vessels. It results in bluish discoloration of the foot due to blood accumulation from the punctured artery or vein or numbness of the foot due to the injured nerve. This condition has to be addressed as soon as possible as it can end up in permanent damage to the vessels and the functions of the foot.

• Arthritis: Arthritis is a clinical condition occurring long after the management of a broken foot but it is characterized by pain and inflammation reactivated in people with old age. It happens if the fracture segment involves bony joints, as arthritis is an inflammatory condition affecting the bone.

• Infection: Infection is a prevalent complication post fractures, and open fractures play an essential role in the transmission of infections. The infection has to be treated with systemic antibiotics and IV fluids as it could lead to osteomyelitis (an inflammatory condition of the bone resulting in severe pain)

What Can the Fracture Be Diagnosed in Comparison?

A broken foot is most often confused or misdiagnosed with a sprain. A foot sprain is a musculoskeletal deformity due to a stretch or tears in the ligament or tissues without involving the bones.

Conclusion:

A broken foot is a clinical condition involving the fracture of the foot bones. It can be a single-bone involvement or usually a multiple-bone involvement. Though the situation is not life-threatening, it is crucial to treat it immediately to restore its function, as the foot plays a big part in carrying the body's weight, locomotion, and posture. With proper medical and surgical treatments and external aid like shoes and crutches, we can very well restore the functions of the foot.