How is a fracture treated?
The therapy depends very much on which bones on the foot are broken and to what extent they have suffered a malposition. Simple fractures of individual metatarsal bones without displacement from the skeleton can normally be treated with a four-week plaster cast and appropriate immobilization. After that, weight bearing is often possible relatively quickly.
As soon as there is a malposition that cannot be corrected by plaster treatment, the bone must be brought back into its original position by means of an operation. The surgeon uses either screws or so-called Kirchner wires. This procedure is also called screw osteosynthesis.
Often no large, open surgery is required, but small external skin incisions are sufficient. After the operation, a plaster splint and relief through crutches are still necessary in most cases. The screws or wires used usually remain in the foot for life and normally cause no discomfort.
Severe, open fractures with severe swelling must be decongested before the treatment, so that there is no increase in pressure within a plaster cast. To prevent further malpositioning of the foot bones while the soft tissue is decongested, the bones are held in a fixed position with a so-called “external fixator“. Prophylactic antibiotic treatment also prevents bacterial infections.
If the foot is broken, it must first be immobilized and stabilized with a plaster cast or splint. How long a plaster is then needed to allow the fracture in the foot to heal completely depends on the type and location of the injury. If one of the toes is broken, a so-called roof tile bandage is usually applied, which makes movement in the joint impossible and, in various variations, allows neighboring toes to provide mutual stability.
Usually 3-4 weeks are completely sufficient for this bandage.In the case of a fracture in the forefoot or midfoot, a plaster shoe must be worn for 6 weeks in most cases. This ensures that the foot itself is stabilized and stiff. However, the ankle joint should continue to be mobile.
If the heel and the ankle joint are affected by the fracture, the lower leg may also have to be plastered. In this case it is also necessary to immobilize the ankle joint for at least 6 weeks. An orthopedist or trauma surgeon should be consulted on the day of the accident to determine whether and where a fracture is present, or whether only the ligaments or soft tissues are affected.
If the foot is actually broken, the severity of the fracture must be determined. The physician will first determine in a consultation what type of illness is to be expected. The location of the pain and the course of the accident will provide important information. He will then determine which parts of the foot are affected with the help of a physical examination and, if necessary, an X-ray, CT or MRI. Finally, his diagnosis will determine which treatment method is to be used to treat the injury and what kind of care should be taken.