A fracture is not always “just a broken bone”
Foot and ankle fractures range from simple, stable injuries that can heal with immobilisation to complex fractures involving the joint, multiple bones, soft tissues or the alignment of the foot and ankle.
The treatment depends on the location, fracture pattern, displacement, joint involvement, soft-tissue condition and overall health of the patient.
Common injuries include ankle fractures, calcaneal fractures, talus fractures, metatarsal fractures, Lisfranc injuries and stress fractures.
Common symptoms
A fracture may cause:
- Sudden pain after an injury
- Swelling
- Bruising
- Difficulty or inability to bear weight
- Tenderness directly over the injured bone
- Deformity or abnormal position
- Reduced movement
- Pain that increases with standing or walking
How do foot and ankle fractures happen?
Fractures can result from a wide range of injury mechanisms, from a simple twist to high-energy trauma.
How is a fracture diagnosed?
Assessment starts with understanding how the injury occurred and a detailed examination.
Your evaluation may include:
- Location of tenderness
- Swelling and bruising
- Skin and soft-tissue condition
- Foot and ankle alignment
- Ability to bear weight
- Circulation
- Sensation and nerve function
- Associated tendon or ligament injuries
Does every fracture need surgery?
No. Stable and appropriately aligned fractures can often be treated without surgery.
Surgery may be required when the fracture is significantly displaced, unstable, involves an important joint surface, is associated with dislocation, or cannot be maintained in an acceptable position with non-operative treatment.
Non-operative treatment may involve
- Splint or cast
- Walking boot
- Protected or non-weight-bearing
- Gradual progression of weight-bearing
- Physiotherapy and rehabilitation
What does fracture surgery involve?
The principle of fracture surgery is to restore appropriate alignment and stability while protecting the surrounding soft tissues.
Depending on the fracture, treatment may involve:
- Reduction of the fracture
- Plates and screws
- Intramedullary fixation
- Percutaneous fixation
- External fixation in selected severe injuries
- Bone grafting or other reconstructive procedures in selected situations
The exact operation depends on the fracture pattern rather than simply the name of the bone that is broken.
Why does soft tissue matter?
Swelling, bruising, blisters and skin condition can influence the timing and type of surgery.
In some significant injuries, immediate definitive fixation may not be appropriate because operating through severely swollen soft tissues can increase complications.
Recovery after a fracture
Recovery depends greatly on the type of fracture and its treatment.
Rehabilitation may include:
- Protection during the healing phase
- Gradual restoration of ankle and foot movement
- Progressive weight-bearing
- Strengthening
- Balance and proprioception training
- Gait retraining
- Gradual return to work or sport
Possible long-term problems
Depending on the injury, complications can include:
- Stiffness
- Persistent swelling
- Malunion
- Nonunion
- Post-traumatic arthritis
- Persistent pain
- Tendon problems
- Hardware irritation
- Infection
- Reduced strength or function
When is urgent assessment required?
Seek urgent medical attention after an injury if there is:
- Obvious deformity
- Severe or rapidly increasing pain
- An open wound over the fracture
- Significant bleeding
- Numbness or loss of sensation
- A cold or unusually pale/blue foot
- Inability to move the toes
- Severe swelling with concerning skin changes
Frequently Asked Questions
Can a foot fracture heal without surgery?
Yes. Many fractures can be treated without surgery when alignment and stability are acceptable.
How do I know whether my ankle is fractured or sprained?
The symptoms can overlap. Clinical examination and appropriate imaging may be needed to distinguish the two.
Can I walk on a fracture?
It depends on the fracture. Weight-bearing without medical assessment can sometimes worsen displacement or interfere with healing.
Will I need physiotherapy after a fracture?
Many patients benefit from rehabilitation, particularly after immobilisation or surgery.
Can a fracture cause arthritis later?
Fractures involving a joint can increase the risk of post-traumatic arthritis. Ankle fractures, in particular, may lead to stiffness and arthritis in some patients.
Consultation
A properly assessed fracture is the first step toward choosing the appropriate treatment and planning recovery.
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