Foot and toe fractures: Difference between revisions

Latest revision as of 21:11, 22 March 2023

Background

Bones of the foot.

Talus and subtalar joint

Foot and Toe Fracture Types

Hindfoot

Midfoot

Forefoot

Clinical Features

History of trauma
Pain over fracture site

Differential Diagnosis

Foot diagnoses

Acute

Subacute/Chronic

Evaluation

Workup

XR foot and/or toe x 2 view
Consider need for more proximal or distal plain films
Consider non-contrast CT of the foot

Diagnosis

Management & Disposition

Foot and Toe Fractures Management Chart

Fracture	Splint	Disposition
Talus fracture	Posterior ankle splint
Calcaneus fracture	Posterior ankle splint
Lisfranc injury	Posterior ankle splint
Navicular fracture	Posterior ankle splint
Cuboid fracture	Posterior ankle splint
Cuneiform fracture	Posterior ankle splint
Fifth metatarsal fracture Jones	Posterior ankle splint	Ortho follow up 3-5D
Non-fifth metatarsal fracture	Posterior ankle splint	Ortho follow up 2-3 days
Toe Fracture	Posterior Ankle Splint

External Links

https://www.aliem.com/emrad-adult-ankle-foot-cant-miss/

References

Authors:

@@ Line 1: / Line 1: @@
-==Talus==
+==Background==
-*Neck
+[[File:Foot_Bones.jpg|thumb|Bones of the foot.]]
-**High risk of avscular necrosis
+[[File:Subtalar Joint.png|thumb|Talus and subtalar joint]]
-*Body
+{{Foot and toe fractures DDX}}
-**Delay in dx/tx can lead to non-union or subtalar osteoarthritis
-==Calcaneus==
+==Clinical Features==
-===Background===
+*History of trauma
-*Associated injuries are common
+*Pain over fracture site
-*Types
-**Intra-articular (75%)
-***Sclerotic line may be only evidence of impacted fracture
-**Extra-articular (25%)
-***Anterior process fx is most common
-===Diagnosis===
+==Differential Diagnosis==
-*Imaging
+{{Foot diagnoses}}
-**Decreased Boehler's angle (<25') may be only sign of fx (compare w/ opposite side)
-===Treatment===
+==Evaluation==
-*Intra-articular fracture
+===Workup===
-**Immobilization w/ posterior splint
+*XR foot and/or toe x 2 view
-**Non-weightbearing
+*Consider need for more proximal or distal plain films
-**Elevation (very important - fx has high rate of severe swelling)
+*Consider non-contrast CT of the foot
-**Ortho consult
-*Extra-articular fracture
-**Immobilization and close ortho f/u
-===Images===
+===Diagnosis===
-*(A) Normal Boehler's angle and (B) Abnormal Boehler's angle
+<gallery mode="packed">
-[[File:Boehler's_Angle.jpg]]
+File:Boehlers_Angle.jpg|[[Calcaneus fracture]]
+File:CuboidAvulsionFracture.jpg|[[Cuboid fracture]]
+File:A Medial cuneiform fracture.png|[[Cuneiform fracture]]
+File:PMC3497949 10.1177 1941738112459489-fig14.png|[[Fifth metatarsal fracture]]
+File:Lisfranc.jpg|[[Lisfranc injury]]
+File:NavicularFracMark.png|[[Navicular fracture]]
+File:PMC3411541 cmed-5-2012-039f3.png|[[Non-fifth metatarsal fracture]]
+File:Talus Fx.png|[[Talus fracture]]
+File:X-rays of foot phalanx.jpg|[[Toe fracture]]
+</gallery>
-==Fifth Metatarsal==
+==Management & Disposition==
-===Jones Fracture===
+{{Foot and toe fractures}}
-*<1.5 cm from proximal tip of 5th metatarsal
-*transverse
-*ORIF
-===Dancer's (Avulsion) Fracture===
+==See Also==
-*proximal tip of 5th metatarsal (more proximal than Jones)
+*[[Fractures (Main)]]
-*avulsion (spiral) fracture, frequently displaced
+**[[Distal leg fractures]]
-*inversion injury (common in ballet dancers)
+*[[Foot Diagnoses (Main)]]
-*Do not confuse unfused apophysis with a fracture!
+*[[Splinting]]
-*treatment
-** mildly displaced: heal w/ 6 to 8 weeks w/ short leg cast
-** displaced frxs (3-5 mm): may require ORIF
-==[[Lisfranc Injury]]==
+==External Links==
+*https://www.aliem.com/emrad-adult-ankle-foot-cant-miss/
-==See Also==
+==References==
-*[[Foot Bones]]
+<references/>
-*[[Ankle Fracture]]
-*[[Ankle Sprain]]
-*[[Ankle Fracture (Peds)]]
-*[[Lisfranc Injury]]
-[[Category:Ortho]]
+[[Category:Orthopedics]]