Fractured and Fragmented Bones: How They are Treated

The human foot has 26 bones that are all connected with joints, tendons, muscles, and ligaments. Since the foot is used in so many different activities, foot fractures can happen in these bones if hit at a bad angle. Treatment is going to vary depending on the location and severity of the fracture. Before a doctor will discuss the correct course of action, they will run tests, including taking an x-ray, CT, or MRI. If there is a fracture, it will fall into one of the following classifications:

• Fragmented Fracture: the bone is cracked, but still partially joined. The crack in the bone and osseous tissue doesn’t completely cover the width of the bone either.
• Non-Displaced Fracture: a bone is broken, but all the bones have stayed in place.
• Displaced Fracture: when a bone has broken into two pieces and do not line up together.
• Comminuted Fracture: multiple breaks, with the bone separated into more than two pieces.
• Open Fracture: the bone is broken and is sticking through the skin.

Recommended Treatment

Many fractures in the foot don’t require any treatment at all. The bone will heal on its own if it is in the toes and in some sesamoid bone fractures, which are located at the bottom of the big toe. No cast is usually required if the bones are still together, even if the fracture happens on the top of the foot, or in the metatarsal bones. The doctor might recommend wearing stiff-soled to support the foot as it heals, or hard-toed shoes to prevent further injury while also protecting the foot. This is especially true in fragmented fractures where the bone is not completely broken through. Non-displaced fractures can be held together by the muscles and tendons surrounding the injury, not requiring surgery unless the surgeon sees that the bones are unstable and are likely to move.

Surgery is usually required for fractures that fall into the displaced, comminuted, and open fracture categories. An orthopedic surgeon will need to place the bones back in place, sometimes requiring screws, pins, and occasionally rods. The body will still do a lot of healing on its own, but if the bones are not in their proper location, the body will make scar tissue around the bones, keeping all the broken bits where they were placed.

If your fracture requires surgery, you will be given a cast, splint, or boot for your foot. You can help reduce the pain and swelling by elevating your foot, not putting pressure on it for one to three months and taking any prescribed medication. After a few weeks, the surgeon will have you come in for a post-operative check-up, where stitches will be removed, and the range of motion checked. Some injuries require another x-ray to make sure everything is healing together.

If the surgery was successful and everything is healing correctly, the surgeon will refer you to a physical therapist. During a therapy session, patients are given stretches and exercises to strengthen the foot, so you can get back on your feet.

The foot is a complex body part, containing many bones. If you have experienced a fracture there, be prepared to rest a lot. However, in most cases, patients make a full recovery.