Fractures of the
Foot and Ankle
A broken bone in the ankle, midfoot, heel, or toes—from a simple toe fracture to an injury that needs surgery.
What it is:
A fracture is a break in bone. In the foot and ankle that can mean a crack in a toe, a break of one of the long metatarsal bones, a fracture of the ankle bones (tibia, fibula, or talus), a broken heel, or an injury through the middle of the foot. Some fractures stay in place and heal in a boot. Others are displaced or unstable and need the bones put back and held with plates, screws, or pins so the joint surfaces heal in the right position.
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Symptoms
Pain that starts with an injury or, in a stress fracture, builds over days of activity
Swelling and bruising, sometimes traveling into the toes or up the leg
Tenderness over a bone
Difficulty or inability to put weight on the foot
Visible deformity in more serious breaks
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Causes and Risk Factors
Twisting the ankle, a fall, a crush, or a direct blow are typical. Stress fractures develop from repetitive loading—running mileage that jumped too fast, a new training surface—rather than a single event. Bone weakened by osteoporosis, neuropathy, or poor nutrition breaks more easily.
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How It Is Diagnosed
The exam looks for swelling, deformity, skin breaks, and whether the foot is well perfused. X-rays are the first study. Some fractures (especially in the midfoot) are easy to miss if the films are not taken standing or with special views. CT is used when the joint surface is involved or the pattern is complex.
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Nonsurgical Treatment
Many foot and ankle fractures heal without an operation if the pieces are well aligned and the joint is stable.
Protection in a splint, cast, or walking boot for the time the bone needs to knit
Weight-bearing instructions specific to the fracture—some breaks allow walking in a boot, others do not
Elevation early on to control swelling
Follow-up X-rays to confirm the bones have stayed in place
Therapy once the bone is ready, to restore motion and strength
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Surgical Treatment
Surgery is recommended when the break is displaced, the joint surface is uneven, the ankle is unstable, or the alignment cannot be held in a cast. The goal is to restore length, alignment, and the smoothness of any involved joint. Hardware is chosen for that bone and is not always removed later. Time on crutches or in a boot depends on which bone was broken. Swelling after a foot or ankle fracture often lasts months, even when the bone has healed.
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When to See a Specialist
Go to an emergency department for an open wound over the break, a foot that is cold, pale, or numb, severe deformity, or if you cannot take four steps after an ankle injury. Call the office promptly for a suspected fracture that is less dramatic: a toe that stays swollen, pain in the midfoot after a twist, or activity-related bone pain that is getting worse rather than better.
FAQs
Which fractures are most common?
Ankle fractures, fifth-metatarsal fractures (including the bump at the base of the little-toe metatarsal), toe fractures, and metatarsal stress fractures are the ones seen most often in clinic. Heel, talus, and midfoot fractures are less common but more often require surgery.
Does every broken bone need surgery?
No. Stability and alignment decide that, not the word “fracture” by itself. A well-aligned toe or metatarsal fracture and many stable ankle fractures are treated in a boot or hard-soled shoe.
How long does healing take?
Bone typically takes six to eight weeks to knit, longer in the hindfoot or in people who smoke or have diabetes. Swelling and stiffness often outlast the X-ray healing date.
Get the Right Care for
Your Foot or Ankle Fracture
If this condition is limiting your walking, work, or shoes, schedule an evaluation. A focused exam and X-rays, when needed, will clarify the diagnosis and the least invasive plan that can get you comfortable again.