Whether the result of a sudden impact, a fall, or a heavy object gone astray, foot fractures are as common as they are pesky. But with the diagnosis comes the looming question — do I really need to wear a cast?
Our Southern California orthopedic experts at Coastal Ortho have the answer.
Here, we give you the lowdown on foot fractures, their treatment, and how to get through the immobilization period and back to your full stride.
Before we tackle the cast conundrum, let’s define foot fractures.
First, foot fractures are prevalent because the odds of breaking a bone in your foot are higher than other body parts — your foot has approximately 26 bones, 33 joints, and over 100 tendons, muscles, and ligaments. One misstep can spell trouble for the whole appendage.
We classify foot fractures into several types: Closed or simple, open or compound, and displaced or nondisplaced, with an array of Latin descriptors that signify the nature of the blow.
Diagnostic measures range from old-school physical examinations, where tenderness and pain strongly indicate the break within, to advanced diagnostic imaging scans like X-rays and MRIs — the modern-day crystal balls that reveal the hidden fractures.
Fractures of the forefoot bones (metatarsals and phalanges) often require a cast. Specifically, a cast is crucial if you’re dealing with a significant break that has led to displacement, nonalignment, or potential instability. It’s like scaffolding around a cracked building, stabilizing the structure while the bone tissue repair occurs.
Your cast may be the conventional hard plaster or fiberglass, tailored to fit snugly around your injured foot and lower leg, secured enough to endure daily wear and tear. The purpose is simple — to keep the broken bits in place while your body performs its miraculous routine of creating new bone material to close the gap and regenerate.
Not all foot fractures need the same level of immobilization. Here are some of the most common fractures and how we treat them.
Ankle fractures demand immediate and expert attention, and they typically call for a cast to ensure proper healing. If you suffer a severe ankle injury, you may need surgery, especially if the bones are markedly separated or misaligned. Our Coastal Ortho specialists can restore your ankle’s original architecture and function.
Nestled within the midfoot, metatarsal bones form the arches and bridges of your feet. Fractures here vary significantly in their need for immobilization.
While some fractures may heal well with the support of a stiff-soled shoe, offering protection and slight pressure offloading, others, particularly those with misaligned bones or segments, may require surgical intervention to realign and fixate the bones properly.
The sesamoids, tiny navigators at the base of your big toe, can fracture, leading to significant pain and mobility issues. Treatment often relies on nonsurgical interventions, like padded soles, to alleviate discomfort. However, persistent or complex fractures may necessitate the surgical removal of the sesamoid bone to restore pain-free movement.
Though small, the toes play a crucial role in balance and movement. Fractures in this area can often heal on their own, with or without the need for a cast. Treatment often focuses on minimizing movement to allow natural healing processes to knit the bone together.
If your foot fracture isn’t severe, you may be a candidate for one of the milder cousins of the cast — the walking boot and the sturdy brace or splint. These cousins cater to fractures that veer toward the edge of needing full immobilization.
A walking boot or a brace can offer support and flexion, allowing some movement while guarding against strain that delays healing. These alternatives often come into play with less severe fractures, where there’s no threat to proper alignment or stability.
Not wearing a cast prescribed for a foot fracture can lead to several complications.
Without the stability and support a cast provides, the healing process will take longer.
There’s also a risk of improper bone healing, a condition known as malunion or nonunion.
Additionally, forgoing a cast when needed can increase your risk of avascular necrosis, a condition where bone tissue dies due to a lack of blood supply.
Our Coastal Ortho team advises you about the best treatments for your unique condition and discusses the specific risks.
To cast or not to cast — that’s the question, and proper healing depends on getting the answer right. Don’t take chances; if you have a broken foot or ankle, call Coastal Ortho in Torrance or El Segundo, California, for an expert diagnosis and treatment.