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Bone fractures in the foot and ankle can happen to anyone, at any time. Seeking treatment for fractures is very important in order to ensure healing takes place as quickly as possible. A fracture refers to an injury or break to the bones. There are many types of fractures, ranging from small hairline fractures to traumatic bone breaks. Although minor fractures can heal on their own, more serious fractures will require surgery.

If you’ve experienced a fracture in your foot and/or ankle, you’ll need to be treated by an orthopaedic surgeon who has knowledge of the intricate workings of the bones, tendons, ligaments and muscles of the foot and ankle. The multidisciplinary team at the Penn Fracture Clinic is highly skilled in the latest surgical techniques for even the most difficult-to-treat fractures, including complex non-union fractures.

Our orthopaedic specialists create personalized treatment plans that encompass every stage of your care including diagnosis, treatment, rehabilitation and aftercare. Your treatment will depend on the severity of the fracture and where the injury has occurred.

Foot and Ankle Fracture Causes

The structure of the foot and ankle contains many bones intricately working together, and if just one of these bones are fractured it can cause extreme pain and greatly impair mobility. It’s important to immediately seek treatment if you have suffered a foot and/or ankle fracture to ensure a complete recovery and have function restored as quickly as possible.

You are more susceptible to fractures if the bones, ligaments and tendons in your foot and ankle are weak. Fractures occur when there is trauma to the bone. Trauma may include:

  • Rolling the ankle either in or out, or twisting it from side to side
  • Over-flexing or over-extending the joint
  • Applying too much force to the ankle or foot (i.e. jumping down forcefully)
  • Blunt force (a heavy object falling on the foot or ankle, or a hard fall)

Foot and Ankle Fracture Symptoms

If you’re experiencing any of the following symptoms, it is very important that you get checked by your doctor to determine if you have a fracture:

  • Throbbing pain
  • Increased pain during activity and decreased pain during rest
  • Bruising
  • Inflammation, redness and tenderness
  • A deformity of the bone in the foot and/or ankle
  • Difficulty walking
  • Difficulty bearing weight

How to Diagnose Foot and Ankle Fractures

To diagnose a foot and ankle fracture, you should be seen by an orthopaedic specialist to assess the severity of the injury and determine a plan for treatment. Imaging tests will likely be ordered, which may include:

  • Musculoskeletal ultrasound
  • MRI
  • CT scans
  • Weight-bearing CT scan

There are several types of fractures:

  • Comminuted fracture: the bone is broken into more than two pieces
  • Extra-articular fracture: the break does not extend into the joint
  • Intra-articular fracture: the break extends into the joint
  • Open fracture: the fractured bone breaks the skin

Foot and Ankle Fracture Treatment Options

In some cases, if the fracture is mild and non-displaced (meaning the bone hasn’t shifted out of place), non-surgical treatment may be able to heal it. To treat foot fractures and ankle fractures without surgery, we typically follow the RICE protocol:

  • Rest: Rest is key. Staying off your injury will help you heal faster. You will likely wear a cast to help keep the foot and ankle immobilized.
  • Ice: Ice the area for 20 minutes at a time to help with swelling and inflammation. Continue icing every 40 minutes.
  • Compression: Wrapping the injury helps control swelling.
  • Elevation: Keep your foot and ankle raised slightly above the level of your heart to help reduce inflammation.

Foot and Ankle Fracture Surgery

If you have a more serious fracture, surgery is usually necessary to repair the fracture as well as any ligaments, tendons and muscles that have been damaged. Our orthopaedic surgeons are experts in fracture repair of the foot and ankle. We have the expertise to treat complex cases, including broken bones that haven’t healed properly (called non-union) and other types of traumatic fractures.

For complex wounds of the foot, we have a unique program called the Orthoplastic Limb Salvage Center, where a specialized team of orthopaedic surgeons and plastic surgeons work together to determine a plan for reconstructive surgery and operate together. Orthopaedic foot and ankle surgeons have expertise in treating all types of bone fractures and performing bone-grafting procedures, while plastic surgeons have specialized training and knowledge of soft tissue injuries that may accompany traumatic fractures.

The Penn Orthoplastic Limb Salvage Center is the only program of this kind in the U.S. that provides this level of integrated care and expertise in microsurgical and complex fracture treatment. All of the surgeons are accustomed to treating injuries that require multiple surgeries at the same time, including re-plantation of limbs and toes and specialized microvascular procedures to repair bones and soft tissues. We consistently combine highly advanced surgical specialties that ensure the best possible outcome for more serious fractures and wounds of the foot and ankle and prevent limb amputation for those at risk.

Some of the surgical treatments for foot and ankle fractures that we often perform are fixation surgery, non-union surgical repair and reduction surgery.

Ankle Fracture Fixation Surgery

If the fracture in your foot or ankle is displaced, or has caused misalignment of the bones, your orthopaedic surgeon will need to put the bones back into the correct position using specialized hardware such as plates, screws or pins. If necessary, we will perform bone grafting and may need to reconstruct soft tissues such as ligaments and tendons.

Non-Union Ankle Fracture Surgery

 A non-union is a broken bone that did not heal properly. Treatment may entail surgery to remove an infection if present, to better stabilize the fracture, or to stimulate bone growth with a bone graft.

Our surgeons perform complex non-union surgical repair with vascularized bone grafting. Vascularized bone grafts allow living bone tissue to be transplanted to replace bone tissue that is damaged.

We are one of the few medical centers in the nation who perform vascularized bone grafting.

Foot and Ankle Reduction Surgery

If the fracture in your foot or ankle is displaced, or has caused misalignment of the bones, your orthopaedic surgeon will need to put the bones back into the correct position using specialized hardware such as plates, screws or pins. If necessary, we will perform bone grafting and may need to reconstruct soft tissues such as ligaments and tendons.

Foot and Ankle Fracture Surgery Recovery

Depending on the severity of your foot and/or ankle fracture, it can take anywhere from several weeks to several months to fully recover. Speak with your doctor about what recovery may mean for you.

Healing takes time, and even after the pain wears off it is important to take it easy. Your doctor will likely advise you to go slowly when resuming normal activity. Physical therapy may be necessary to rebuild strength in healing bones, muscles, ligaments and tendons. Your doctor will create an individualized recovery plan to ensure you receive the best possible outcome and quickest recovery.

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