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If you are reading this information because you have a foot or ankle fracture, first, I want to express that I’m sorry about your misfortune. Second, I want to let you know that I will do my best to help you to the best possible outcome. My goals are to 1) get the fracture to heal in an alignment as close to the pre-injury alignment as possible, and 2) to minimize risks and maximize your potential to return to your pre-injury functional status. To this end, I have developed this resource to inform you about foot and ankle fractures, and answer as many questions that you might have about your fracture as possible.
Variations on a theme – not all foot and ankle fractures are the same!  The severity of fractures can vary, depending on 1) the amount of force or energy that caused the fracture and how fragmented the bone is, 2) whether the bone was exposed through the skin, 3) the specific bone or location in the foot or ankle, 4) whether a joint was disrupted, and 5) whether a growth center was disrupted. Furthermore, fractures heal at different rates, depending on 1) your age, 2) your circulation, 3) the specific bone involved, 4) your health, 5) medications that you might be taking, 6) whether you smoke, and 7) how protected the fracture is while healing.

Therefore, some fractures may require minimal immobilization and weight bearing is allowed, while others may require surgery, extensive casting, and non-weight bearing. Some fractures will heal with no long-term consequences, while others may result in long-term problems, even with the best of care. Because of these complexities, I will discuss the nature of your fracture, the risks involved, and the appropriate management of your fracture with you. If you have any remaining questions or concerns, please contact us .

Step 1 – Treating a foot or ankle fracture, make sure the fracture is in satisfactory alignment.

Some fractures are virtually non-displaced, meaning that the pre-injury alignment of the bone has not changed. Lay terminology might refer to these types of fractures as “hairline”. In non-displaced fractures, step 1 is accomplished and the treatment can move on to step 2. Other fractures might involve varying degrees of displacement or shifting. Some bones and locations in the foot or ankle have a good tolerance of mild displacement, so that no additional “setting” of the fracture is required. However, other displaced fractures demand restoration to an alignment as close as possible to the pre-injury alignment. Examples include those that involve disruption of important joints, or those that involve growth centers in pre-adolescent children. In some of these types of fractures, surgery may be required to restore the alignment, while in others, non-surgical “setting” or “reduction” of the fracture is sufficient to restore proper alignment.

Step 2 – Treating a foot or ankle fracture, stabilize the fracture, so that it does not shift out of place or displace.

In some cases, the surgical implantation of bone screw and plates are utilized to stabilize your fracture. In most cases, fractures are stabilized with some form of immobilization, whether surgery was performed or not. Immobilization may vary from a fiberglass cast to a foot and leg splint, to a removable walking cast, to buddy splinting two toes together. I will advise you on which method of immobilization (stabilization) is best for your fracture.

Step 3 – Treating a foot or ankle fracture, stabilize the fracture long enough for the body’s healing process to mend the fracture.

Foot and ankle fractures typically take a minimum of 6-8 weeks to calcify enough to become internally stable enough to begin to reduce the need for external stabilization. It is at this time that it will be safe to progress you to the next level of recovery. However, fractures will take 3 months or more to completely heal and remodel. Therefore, even though I will begin to eliminate external stabilization of your fracture, the fracture will still be “healing”. Because fractures take 3 months or more to completely heal and remodel, you may experience some tenderness and swelling for at least 3 months or more following the fracture.

Step 4 – Treating a foot or ankle fracture, restore function.

Many foot and ankle fractures require some type of rehabilitation to return to full function, particularly when the foot and ankle have been in a cast for weeks. In most cases, I will give you instructions on the type, frequency, and duration of rehabilitation activities. These activities may include range of motion exercises, icing, contrast baths, and strength work that you perform on your own. In some cases, working formally with a physical therapist may be required, for which I make a referral. Rehabilitation activities may be started once your cast is removed. In most cases, rehabilitation activities will last for another 2-12 months


To Conclude

I hope that the information provided here has enhanced your knowledge about how I will be managing your fracture to achieve the best possible outcome for you, and how you can help your cause. Should you have any unanswered questions, please contact us by Kaiser Permanente’s Secure Message e-mail system, or by phone at 707-570-3120.

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