Introduction
Background
Approximately 10% of all fractures occur in the 26 bones of the foot. These bones comprise 2 bones in the hindfoot (calcaneus, talus), 5 bones in the midfoot (navicular, cuboid, 3 cuneiforms), and 19 bones in the forefoot (5 metatarsals, 14 phalanges). In addition, the foot contains sesamoid bones, most commonly the os trigonum, os tibiale externum, os peroneum, and os vesalianum pedis. Their smooth sclerotic bony margins and relatively consistent locations help distinguish them from fractures. Hindfoot connects to the midfoot at the Chopart joint; forefoot connects to the midfoot at the Lisfranc joint.
Below is an example of a common fracture.
Fractures, foot. Proximal fifth metatarsal avulsion fracture (also termed pseudo-Jones, tennis, or dancer fracture).
Age
In contrast to adults, children have relatively stronger ligaments than bone or cartilage. As a result, fractures are more common than sprains in children. However, a child's forefoot is flexible and resilient to injury. When metatarsal or phalangeal fractures do occur, they may be difficult to recognize because of multiple growth centers. In such cases, comparison views of the uninjured foot often are helpful.
Clinical
History
- Mechanism of injury
- Time between injury and presentation
- Prior injuries
Physical
- Inspect injured foot for swelling, bruises, deformity, and open wounds.
- Uncover uninjured foot for side-by-side comparison.
- Palpate for pulses, capillary refill, tenderness, instability, and crepitus.
- Test range of motion and joint function. Normal ranges of motion of the foot relative to the ankle are 45 degrees plantarflexion, 20 degrees dorsiflexion, 30 degrees inversion, 20 degrees eversion, 20 degrees internal rotation, and 10 degrees external rotation. Comparisons with the uninjured foot are helpful.
- Explore all open wounds.
- Conduct and document a careful neurologic exam of foot, including both motor and sensory functions.
Causes
Trauma - Direct, indirect, or overuse
More on Fracture, Foot |
 Overview: Fracture, Foot |
| Differential Diagnoses & Workup: Fracture, Foot |
| Treatment & Medication: Fracture, Foot |
| Follow-up: Fracture, Foot |
| Multimedia: Fracture, Foot |
| References |
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References
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Further Reading
Keywords
broken foot, toe fracture, broken toe, first metatarsal fracture, internal metatarsal fracture, fifth metatarsal fracture, proximal avulsion fracture, Jones fracture, Jones' fracture, fracture at Lisfranc joint, fracture at tarsometatarsal joint, talar fracture, navicular fractures, calcaneal fractures, March fracture, pseudo-Jones fracture, tennis fracture, posterior process fracture, Shepherd fracture, transchondral talar dome fracture, osteochondral talar dome fracture, intraarticular joint depression fracture, compartment syndrome
