Ankle, Foot, and Toe Fractures

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A bone fracture is another term for a broken bone. Fractures can range from small cracks in the bone (hairline fractures) to breaks that have separated the bone into three or more pieces (comminuted fractures).

Your ankles, feet and toes are made up of some the most commonly injured bones and joints in the body, which makes them some of the most prone for breaks as well.

The ankle is a hinge-type joint that connects the leg to the foot. Three bones fit together snugly here, and are supported by strong ligaments. An ankle fracture is a break of one or more of these bones. These fractures can sometimes be mistaken as sprains, as the symptoms are very similar.

The foot (including toes) is very complex – made up of 33 joints, more than 100 muscles, and 26 bones varying in size. The foot is also broken up into 3 parts:

  • Forefoot – toes (phalanges) and the metatarsals
  • Midfoot – arches and top of foot
  • Hindfoot – heel to the ankle

Dealing with fractures in your feet and toes can be tricky with the numerous bones, joints, and muscles of varying sizes that need to be considered.


Ankle, foot, and toe fractures are very common in athletes, but can happen to anyone with just one misstep.

Some of the most common causes of ankle fractures are:

  • Rolling the ankle (in or out)
  • Severely twisting the ankle
  • Over extension
  • Severe impact & direct force on the ankle
  • Poor footwear
  • Osteoporosis
  • Overuse

Some of the most common causes of foot and toe fractures are:

  • Impact, such as kicking something hard or dropping weight on the foot
  • Falling, when landing directly or awkwardly on your foot or feet
  • Overuse
  • Poor conditioning
  • Poor footwear
  • Severe bending of the foot or toes

Breaks in the foot and ankle don’t always occur immediately after an injury or trauma. Trauma to the foot and ankle can weaken your supporting muscle and tendons, which places pressure on parts of your foot and ankle that aren’t designed for so much stress. Without proper initial treatment of the original injury, this newly allotted pressure and stress can lead to a break.

What Causes Stress Fractures?

One of the most common fractures, specifically in the feet, are stress fractures (not to be confused with compression fractures, which refers to specific spinal breaks). Stress fractures are small cracks in the bone that have usually developed over time. These fractures are most common in athletes, and individuals who are on their feet a lot, due to overuse and repetitive movements. Those with osteopenia or osteoporosis also face stress fractures quite often due to their weaker, and somewhat brittle, bone densities.

Stress fractures generally start as small cracks that can be easily treated by one of our podiatrists. However, left untreated the bone may snap or become dislocated, which may require surgical correction.


Ankle & Foot
To detect a fracture in the ankle or foot there are several symptoms and identifying characteristics you can look for:

  • Bruising
  • Deformity (bones becoming misaligned and misshapen)
  • Swelling
  • Pain (often severe)
  • Hearing a “snap” or “pop” at the time of the injury
  • Trouble walking or bearing weight

Because the foot and ankle are made up of so many small and intricate bones, you may not immediately realize you’ve sustained a fracture. That’s why it’s so important to get a professional examination if you’re facing continued irritation and discomfort in your foot or ankle.

Broken toes are some of the most common breaks of the foot and are usually associated with:

  • Severe bruising
  • Intense & throbbing pain
  • Swelling
  • Deformity
  • Difficulty walking

Broken toes in athletes are also very common. Broken big, or great, toes are particularly common in athletes and those who maintain active lifestyles. These breaks are often referred to as “turf toe.” Turf toe is caused by excessive and repetitive pushing off of the big toe when making explosive movements (e.g. running & jumping), and can vary from a sprain to a broken bone with ligament damage. If you’re experience severe pain from your big toe after athletic or strenuous activity you may need to be examined for a break.

Care & Treatment

When a podiatrist examines an injured ankle they usually check for several injuries: sprains, injured tendons or ligaments, and fractures. Unless the ankle has a protruding bone, or has become severely misshapen, a podiatrist may need to have an x-ray taken of the ankle to fully diagnose a fracture.

Once you’ve been diagnosed with an ankle fracture there are several ways to care and treat it:

  • Rest
  • Keep pressure off of the injury
  • Ice the ankle
  • Wearing a splint or cast for realignment
  • Pain medication
  • Elevating the ankle

Depending on intensity of the break, your ankle may require surgical correction as well. Through surgery, a podiatrist can help make sure the bone will heal correctly and in alignment, which can prevent future issues and arthritis.

During a typical ankle surgery, the bones are realigned and then stabilized with screws or plates. The patient is then placed in a cast, splint or boot for a variable period of time until the fracture has properly healed.

The strategy for diagnosing broken bones in the foot can vary greatly depending on the location of the injury. At times a podiatrist may only need to do an examination to determine if there are any bone fractures, but often times some form of imaging is necessary.

Foot fractures can call for a variety of treatments including:

  • Splints
  • Elevation
  • Ice the foot
  • Rest
  • Crutches
  • Casting
  • Protective & supportive footwear

Depending on the location and severity of the fracture, a surgical procedure may be necessary to repair the break. Post-surgery recovery may require you to be non-weight bearing for a period of time, followed by limited daily use of the foot until the overseeing podiatrist feels the foot has properly healed.

Broken toes don’t usually require x-rays as both broken and badly bruised/injured toes are often treated with the same methods.

Broken and injured toes are often treated through:

  • Ice
  • Rest
  • Splinting, known as “buddy taping,” which is when the broken toe is taped alongside a neighboring healthy toe
  • Casting, if the toe has become dislocated
  • Wearing podiatrist-provided stiff-soled shoes to support the fracture
  • Pain & anti-inflammatory medication

Fractures of the big, or great, toe are often more severe than breaks to the others. If the joint is disrupted or the bones have become dislocated, the toe may require surgery.

Improper or Delayed Treatment
If ankle, foot, and toe fractures are not properly handled, or treatment is delayed you may experience a wide range of consequences and side effects, including:

  • Motion limiting deformity
  • Development of arthritis around the fracture
  • Non-healing & worsening of the fracture
  • Development of chronic pain
  • Compound fractures & infection

Early examination and treatment of any foot, toe or ankle fracture is essential to a positive outcome. Our podiatrists have extensive training and experience in the non-surgical and surgical treatments of these fractures.

Once a fracture has been identified, your podiatrist will develop a treatment plan for your specific injury. They will also strive to correct your injury non-surgically first and will only recommend surgery when absolutely necessary.

Experiencing foot, toe or ankle pain? Contact us today and schedule an appointment at one of our four Middle Tennessee locations.

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