City Footcare NYC

Podiatric Medicine & Surgery

We treat all problems of the foot and ankle.

Fractures

Definition:

A fracture is a break in a bone.

There are generally 2 types of fractures that are seen in the foot. A traditional fracture is a through and through fracture that is usually caused by some traumatic event. Usually it is caused by force on the bone that happens all at once.

A stress fracture is a fracture that occurs slowly over many episodes of repetitive forces. Repetitive forces can be as simple as walking and a severe as sprinting.

An analogy that I like to give to my patients to explain the two kinds of fractures listed above is visualizing a break in a pencil verses a paper clip.

The pencil represents a traditional fracture. Force is applied at one time snapping the pencil in half.

The paper clip represents a stress fracture. A bending force is applied over and over again which breaks the internal structure of the paper clip prior to it breaking all the way through. The internal structure of the metal is damaged slowly and eventually will break all the way through. The same happens in the bone.

Cause:

Close to 1 in 4 of all the bones in your body are in your feet. A broken (fractured) bone in your forefoot or in one of your toes, while often painful, is rarely disabling. Most of the time, these injuries heal without the need for surgical intervention. Types of fractures include stress fractures and traditional bone fractures.

Stress fractures frequently occur in the bones of the forefoot extending from your toes to the middle of your foot. Stress fractures are the very tiny cracks in the bone tissue. They can occur with rapid increases in training (such as running or walking for longer distances or times), improper training techniques or changes in training surfaces.

The other types of fractures extend through the bone. They may be stable and not misaligned, in which there is no shift in bone alignment, or there may be displacement, in which the bone ends no longer line up properly. These fractures usually result from trauma, such as dropping a heavy object on your foot, a fall from height, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. If the bone does not break through the skin and it is called an open fracture.

An twisting injury may tear the tendon that attaches to this bone and pull a small piece of the bone away. This is called an avulsion fracture.

A common injury occurs at the base of the fifth metatarsal. Called a Jones fracture, this is an avulsion fracture of the base of the fifth metatarsal. It often occurs as a result of a twisted ankle. The reason it is common in this area is that there is a known area of decreased blood supply.

The decreased blood supply may result in this injury not healing, or taking longer to heal and often requires surgery.