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| ==Hindfoot== | | ==Types== |
| ===Talus===
| | [[File:Foot_Bones.jpg|thumb|Bones of the foot.]] |
| ====Background====
| | {{Foot and toe fractures DDX}} |
| *Almost always associated with other injuries
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| ====Diagnosis==== | | ==See Also== |
| *CT often required for accurate diagnosis | | *[[Fractures (Main)]] |
| | | **[[Distal leg fractures]] |
| ====Management====
| | *[[Foot Diagnoses (Main)]] |
| *Major fracture (talar neck and head)
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| **Immediate ortho consultation required (high rate of avascular necrosis)
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| *Minor fracture | |
| **Posterior splint, NWB, ortho referral | |
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| ===Calcaneus===
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| ====Background====
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| *Associated injuries are common
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| *Types
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| **Intra-articular (75%)
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| ***Sclerotic line may be only evidence of impacted fracture
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| **Extra-articular (25%)
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| ***Anterior process fx is most common
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| ====Diagnosis====
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| *Imaging
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| **Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side)
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| ====Treatment====
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| *Intra-articular fracture
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| **Immobilization w/ posterior splint
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| **Non-weightbearing
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| **Elevation (very important - fx has high rate of severe swelling)
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| **Ortho consult
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| *Extra-articular fracture
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| **Immobilization and close ortho f/u
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| ====Images====
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| *(A) Normal Boehler's angle and (B) Abnormal Boehler's angle
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| [[File:Boehlers_Angle.jpg]] | |
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| ==Midfoot==
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| ===LisFranc Injury===
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| *See [[Lisfranc Injury]] | |
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| ===Navicular/Cuboid/Cuneiform===
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| *All are diagnosed/managed in similar way
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| **Imaging: (weight-bearing AP, lateral, oblique)
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| ***CT sometimes necessary
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| **Treatment: Non-weightbearing short leg cast, ortho referral
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| ==Forefoot==
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| ===Fifth Metatarsal===
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| ====Background====
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| *3 types of fractures:
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| **1. Tuberosity (styloid) avulsion fracture
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| ***Most common fx at base of 5th metatarsal
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| ***Sx often mild, pts usually present with sprained ankle complaint
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| ***Occurs due to forced inversion foot/ankle while in plantar flexion
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| **2. Jones or metaphyseal-diaphyseal junction fracture
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| ***Occurs due to sudden change in direction w/ heel off the ground
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| **3. Diaphyseal stress fracture
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| ***Occurs through repetitive microtrauma
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| ====Diagnosis====
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| *Plain radiographs are usually adequate
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| [[File:Foot fx.png|center|frame|5th Metatarsal fx types]]
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| ====Management====
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| *Tuberosity (Styloid) Avulsion Fracture
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| **Refer to ortho if > 3mm displacement
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| **Nondisplaced fx usually require only symptomatic tx
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| **Walking boot (casting rarely necessary) and weightbearing as tolerated, f/u in 1 week
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| *Jones Fracture (non-displaced)
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| **Posterior splinting, NWB, ortho referral
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| *Diaphyseal Stress Fracture
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| **Ortho referral
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| ===Metatarsal===
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| ====Background====
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| *Must rule-out associated Lisfranc injury
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| ====Management====
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| *Posterior splint, NWB, ortho referral in 2-3d
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| ===Phalange=== | | ==References== |
| *Management: buddy-taping, hard-soled shoe
| | <references/> |
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| ==See Also==
| | *Uptodate |
| *[[Fractures (Main)]] | |
| *[[Foot Bones]]
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| *[[Ankle Fracture]]
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| *[[Ankle Sprain]]
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| *[[Ankle Fracture (Peds)]]
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| *[[Lisfranc Injury]]
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| ==Source==
| | [[Category:Orthopedics]] |
| *Tintinalli
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| *Ilustration by Dr. Frank Gaillard; CC SA NC BY licence
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| *http://radiopaedia.org/articles/jones_fracture
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| [[Category:Ortho]] | |
