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Foot & Ankle

imageFOOT & ANKLE FRACTURES
A fracture is a break in a bone. It may be a crack in the bone (a stress fracture) or a complete break; the bones may shift out of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break as well as the patient’s overall health.

Digits (toes/phalanges) and metatarsals (long bones of the forefoot) – There are many different kinds of fractures that can happen to the bones of the forefoot and toes. They are painful but often heal without the need for surgery. The metatarsals are prone to stress fractures, or cracks in the bone. These are usually related to a recent increase or change in activity. The fifth metatarsal below the small toe may fracture if it is landed on badly or if the ligament of a twisted ankle pulls off a piece of the bone. Symptoms of a toe or metatarsal fracture include pain that gets worse when walking; swelling; and sometimes bruising.

Lisfranc joint (midfoot) - Often caused by dropping something heavy on the top of the foot or by falling after catching the foot in a hole. Symptoms are similar to a sprain and include swelling and pain at the top of the foot; bruising; possible inability to bear weight; and pain when moving the foot while the ankle is held steady. If you think you have a sprain and it does not improve with rest and ice after one to two days, you may have a Lisfranc joint fracture and should see a doctor to prevent further injury.

Calcaneus (heel) - Usually the result of an automobile accident or fall from a great height. Symptoms include pain on the outside of the ankle or under the heel; inability to bear weight; swelling and stiffness. May be accompanied by back or knee injury due to the amount of force required to break the heel bone.

Ankle - Like severely sprained ankles, broken ankles are often caused by a fall, injury or car accident. Symptoms that one or more of the three bones that make up the ankle may be fractured are: severe pain in the ankle; swelling; bruising; tenderness; inability to bear weight; and deformity of the joint. May be accompanied by dislocation or ligament damage (sprain).

ANKLE ARTHRITIS
Like any other joint in the body, the ankle can be affected by arthritis, a chronic condition that can cause pain, swelling and stiffness and an eventual loss of motion in the affected area. The ankle is the joint that connects the shinbone (tibia) to the upper bone of the foot (talus). Although the ankle is not affected by arthritis as commonly as other joints such as the hand and hip, it is still a serious condition that can cause severe pain for those affected.

Treatment for ankle arthritis depends on the type and severity of the condition, but usually begins with the most conservative methods. Some patients may experience relief from their symptoms by wearing more comfortable shoes, wearing cushioned shoe inserts, limiting impact activities and wearing a brace. Anti-inflammatory medication and cortisone injections are often helpful in relieving pain temporarily, especially during flare ups.

If these treatments are unsuccessful, patients may benefit from more advanced treatments such as ankle arthroscopy, ankle fusion surgery or ankle replacement surgery. Your doctor will determine which treatment option is best for you based on your individual condition.

PLANTAR FASCIITIS
There is a ligament along the bottom of the foot called the plantar fascia that stretches from the heel to the base of the toes. If the ligament is forced to stretch beyond its limit, it may become inflamed and result in heel pain. This condition is called plantar fasciitis. Patients often complain of discomfort in the heel, the arch of the foot, or the back of the leg when walking. The pain is usually worst when getting up after sitting or lying down for a while.

Bone spurs are a common complication of plantar fasciitis. These bony calcium growths on the bottom of the heel form where the plantar fascia pulls on the heel bone. Spurs don’t usually cause pain themselves, but they are often a good indicator of the severity and age of the underlying problem.

Risk factors for developing plantar fasciitis and heel spurs include overuse during exercise, standing or walking for many hours a day, having naturally tight calf muscles, wearing shoes with high heels, and having flat feet or very high arches.

For more information on problems of the foot & ankle and the treatments we provide, please call the office nearest you.