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Foot Fractures

Most of us have heard that you cannot walk on a broken foot… However, that is simply not true and you may cause more damage if you leave a fracture untreated! 

If you have experienced an injury that affected your foot and have:

  • Continued pain
  • An inability or difficulty bearing weight on the foot
  • Persistent swelling to the area
  • Deformity

It is important to schedule an appointment with Dr. Castelein to have the affected area assessed.

Schedule an appointment today with Dr. Bryant Castelein, DPM – Podiatry Specialist

foot fractures

Anatomy of Foot Fractures

Talus Fracture:

The talus is the bone that creates the lower part of the ankle joint and allows the foot to move up and down. This bone is also the main connector between the foot and leg. It aids in transferring weight and pressure across the ankle joint. A talus fracture occurs when one of the bones that forms the ankle breaks, usually caused by a high-energy/impact event (car accident, fall, etc). CT scans are typically necessary when diagnosing a talus fracture. When the talus is fractured, a substantial loss of motion and function is usually noted. The talus is a difficult bone to heal, and if healed improperly, complications such as non-union, arthritis, chronic pain or a decrease in foot mobility.

Calcaneal Fracture:

The calcaneus or heel bone lies at the back of the foot, below the bones of the ankle joint. The calcaneus along with the talus form the subtalar joint, which allows foot movement side-to-side and balancing on uneven ground. A calcaneal fracture can be quite severe, resulting in debaliting deformity. It often occurs from a high energy/impact event (car accident, fall, etc.) when the heel becomes crushed under the body. Dr. Castelein will often recommend a CT scan when diagnosing a calcaneal fracture. Due to the typical severity of this injury, surgery is often needed to reconstruct and restore mobility to the foot. Without restoring proper alignment, calcaneal fractures may result in long-term complications such as pain, swelling, and arthritis.

Navicular Fracture:

The navicular bone is one of the five midfoot bones and assists in making the tarsus of the foot and ankle. This bone helps transfer weight from the ankle to the ball of the foot. The navicular is covered in cartilage and lacks good blood supply which results in this area being more susceptible to damage. Navicular fractures are often caused by repetitive stress (excessive running, twisting, jumping) or traumatic injury. Dr. Castelein will use a CT or MRI scan to determine the prevalence and severity of a navicular fracture.These fractures are at high risk of nonunion and loss of bone tissue and often require surgical intervention.

Cuneiform Fracture:

The cuneiform consists of three bones: medial cuneiform, intermediate cuneiform and lateral cuneiform. These three bones interlock with each other to form a bridge between the navicular and metatarsals. This set of bones provides stability vital to walking and running. Cuneiform fractures are rare and typically involve a very high energy/impact trauma event (car accident, fall from height, etc.). A cuneiform fracture is very rarely seen on its own and may be accompanied by a LisFranc or other fracture. CT scans are often needed to affirm a cuneiform fracture. Depending on severity of fracture, a period of non-weightbearing or surgical repair may be needed.

Metatarsal Fractures:

Metatarsal fractures are quite commonly encountered after injury and usually occur as a result of direct trauma to the foot. The first metatarsal is responsible for maintaining balance in the foot and fractures located here are likely to result in dysfunction of the foot. The second through fourth Metatarsal bones are slender and are commonly sites where stress fractures or acute fractures from twisting or direct traumas are noticed. Many times multiple metatarsals may be affected by fracture. Most metatarsal fractures have a favorable prognosis if treated properly. However, fractures that go untreated or unnoticed can result in disabling metatarsalgia or arthritis.

Toe Fracture:

Even though they are quite small, fractures to the toes can be painful. The big toe is made of two bones and is especially important as  one half of your body weight is transferred through it. The smaller toes each have three bones and combined take the other one half of the body’s weight. A broken toe is a common fracture that mostly occurs from dropping something on the foot, stubbing a toe or overuse/repetitive stress. Dr. Castelein uses X-ray to diagnose foot fractures. When needed he can  manually reduce the fracture. He also often recommends changing footwear and immobilization to achieve full resolution. In certain instances surgery may be needed.

Cuboid Fracture:

The cuboid bone is a short, square-shaped bone and is found in the midfoot area of the foot. This bone connects the foot to the ankle and provides overall stability to the foot. Fractures of the cuboid are rare and referred to as a “nutcracker” fracture. Causes are usually related to landing from a high jumping point, repetitive ankle sprains or a crush injury to the foot. Utilizing both CT and X-ray for this fracture is imperative in diagnosis. Cuboid fractures often heal without surgical intervention, however accurate diagnosis of the fracture is needed to determine best course of care.

5th Metatarsal Fracture:

The 5th Metatarsal bone connects the ankle to your little toe and is the long bone on the outside of the foot. Fracturing this bone is a common injury and can occur from an injury event, high arch feet or overuse. The 5th Metatarsal fracture can occur at the midshaft, avulsion or Jones fracture. A midshaft fracture happens to the long portion of the bone. This occurs from twisting and force being directed to the end of the bone. An avulsion fracture involves a small piece of bone pulling away from the main portion of the bone by a tendon or ligament and usually occurs when the ankle is rolled. A Jones fracture exists at a small portion of the 5th Metatarsal bone that has less blood supply (causing slower/lesser healing) and can be from a sudden injury or over time (stress fracture). This fracture may require surgery on young and active patients as it is notorious for a long healing time frame and potential for reinjury.

Diagnosing Foot Fractures

X-Ray:

Dr. Castelein will begin the process of diagnosing a foot fracture with an X-ray taken in our office. The image will display the soft tissues and bones of the foot, allowing Dr. Castelein to diagnose the fracture.

CT Scan:

In some cases, certain fractures may  need further detail and require a CT scan to be performed. The CT scan takes many X-ray images from multiple angles and creates a combined cross-sectional image of the foot to allow Dr. Castelin to further examine the fracture. Many times a CT can be displayed in a 3D image to give a great picture of the fracture and shape of the bone.

Conservative Treatments for Foot Fractures

Conservative treatment for foot fractures is considered when the fracture is mild and non-displaced (the bone has not shifted out of place).

RICE Method:

First, Dr. Castelein will recommend the adaptation of the RICE method during the healing time period. This involves rest, ice, compression and elevation. Resting and staying off of the injured foot will assist in recovery; icing the area for 20 minutes at a time will aid in reducing swelling and inflammation; Compressing the injury with a wrap will help with swelling control; and keeping your foot Elevated above your heart will reduce inflammation.

Walking Boot:

Medical walking boots protect the foot while the fracture is healing. The boot acts as a stabilizer and prevents overuse of the injured bone.  A walking boot is typically used  for a period of six to eight weeks. Typically, you will be able to leave our office with the walking boot in-hand to begin the healing process immediately.

Casting:

In some instances, Dr. Castelein may cast the affected foot to support the fracture. A cast completely immobilizes the foot and ensures no movement is made during healing. The cast will be molded to your foot by Dr. Castelein in our office to ensure the most protection and support. Sometimes, casting is used in combination with a CAM boot for a period of six to eight weeks.

Surgical Treatments for Foot Fractures

When a foot fracture is more severe, displaced, intra-articular fracture or bones that are not healing together properly (non-union), surgery is usually necessary to repair the fracture. The goal of surgery is to align the bone structure to best support the surrounding ligaments, tendons and muscles. Dr. Castelein is board certified to restore bone shape, allow for early range of motion and return to activity quickly. The type of surgery performed is highly dependent upon the type of fracture endured and its severity. Internal fixation is often used to support the bone and allow for healing while external fixation may be needed for complicated fractures. 

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Client Testimonials

Julie
I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
Amy
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Robert
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Joseph
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Lexi
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Christena
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
Ashley
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Alex
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!