Foot and toe fractures: Difference between revisions

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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
 
====Diagnosis====
*CT often required for accurate diagnosis
 
====Management====
*Major fracture (talar neck and head)
**Immediate ortho consultation required (high rate of avascular necrosis)
*Minor fracture
**Posterior splint, NWB, ortho referral
 
===Calcaneus===
====Background====
*Associated injuries are common
*Types
**Intra-articular (75%)
***Sclerotic line may be only evidence of impacted fracture
**Extra-articular (25%)
***Anterior process fx is most common
 
====Diagnosis====
*Imaging
**Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side)
 
====Treatment====
*Intra-articular fracture
**Immobilization w/ posterior splint
**Non-weightbearing
**Elevation (very important - fx has high rate of severe swelling)
**Ortho consult
*Extra-articular fracture
**Immobilization and close ortho f/u
 
====Images====
*(A) Normal Boehler's angle and (B) Abnormal Boehler's angle
[[File:Boehlers_Angle.jpg]]
 
==Midfoot==
===LisFranc Injury===
*See [[Lisfranc Injury]]
 
===Navicular/Cuboid/Cuneiform===
*All are diagnosed/managed in similar way
**Imaging: (weight-bearing AP, lateral, oblique)
***CT sometimes necessary
**Treatment: Non-weightbearing short leg cast, ortho referral
 
==Forefoot==
===Fifth Metatarsal===
====Background====
*3 types of fractures:
**1. Tuberosity fracture
***Occurs due to forced inversion foot/ankle
**2. Jones or metaphyseal-diaphyseal junction fracture
***Occurs due to sudden change in direction w/ heel off the ground
**3. Diaphyseal stress fracture
***Occurs through repetitive microtrauma
 
====Diagnosis====
*Plain radiographs are usually adequate
 
====Management====
*Tuberosity Fracture
**Walking cast and weightbearing as tolerated
*Jones Fracture (non-displaced)
**Posterior splinting, NWB, ortho referral
*Diaphyseal Stress Fracture
**Ortho referral
 
===Metatarsal===
====Background====
*Must rule-out associated Lisfranc injury
 
====Management====
*Posterior splint, NWB, ortho referral in 2-3d
 
===Phalange===
*Management: buddy-taping, hard-soled shoe


==See Also==
==See Also==
*[[Fractures (Main)]]
*[[Fractures (Main)]]
*[[Foot Bones]]
**[[Distal leg fractures]]
*[[Ankle Fracture]]
*[[Foot Diagnoses (Main)]]
*[[Ankle Sprain]]
 
*[[Ankle Fracture (Peds)]]
==References==
*[[Lisfranc Injury]]
<references/>


==Source==
*Uptodate
*Tintinalli


[[Category:Ortho]]
[[Category:Orthopedics]]

Revision as of 18:32, 26 June 2016