Foot Fractures

Fractures in the Feet

Nearly one-fourth of all the bones in your body are in your feet. A broken (fractured) bone in your forefoot or in one of your toes is often painful, but rarely disabling. Most of the time, these injuries heal without operative treatment.

There are two types of foot fractures: stress fractures and general bone fractures. Stress fractures usually occur in the bones of the forefoot extending from the toes to the middle of the foot. Stress fractures are like tiny cracks in the bone surface. They can happen with sudden increases in exercise (such as running or walking for longer distances or times), improper training techniques, or a change in surfaces.

Most other types of fractures extend through the bone, and are called bone fractures. They may be stable, in which there is no shift in bone alignment, or displaced, in which the bone ends no longer line up properly. Bone fractures usually result from trauma, such as dropping a heavy object on your foot, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. If the fracture does break through the skin, it is called an open fracture.

Because of the complex structures in the foot, there are some other, more specific types of fractures that can occur. For example, the fifth metatarsal, known as the little or pinky toe, is susceptible to a variety of different fractures. The relationship between the ankle and the foot can be compromised by an ankle-twisting injury, which may tear the tendon that attaches to this bone and pull a small piece of the bone away. A more serious injury in the same area is known as a Jones fracture, which occurs near the base of the bone and disrupts its blood supply. This injury may take longer to heal or require surgery.

Common symptoms for any type of foot fracture includes pain, swelling, and sometimes bruising. Be sure to seek medical attention for any suspected foot fracture.

Instructions for Crutches

It takes some coordination to get around on crutches. To make sure you use your crutches correctly, please read these instructions and follow them carefully.

Sizing Your Crutches

Even if you’ve already been fitted for crutches, make sure your crutch pads and handgrips are set at the proper distance, as follows:

Crutch pad distance from armpits: The crutch pads (tops of crutches) should be 11/2″ to 2″ (about two finger widths) below the armpits, with the shoulders relaxed.
Handgrip: Place it so your elbow is flexed about 15 to 30 degrees — enough so you can fully extend your elbow when you take a step.
Crutch length (top to bottom): The total crutch length should equal the distance from your armpit to about 6″ in front of a shoe.

Begin in the “Tripod Position”

The tripod position is the position you stand in when using crutches. It is also the position you begin walking in. To get into the tripod position, place the crutch tips about 4″ to 6″ to the side and in front of each foot. Stand on your “good” foot (the one that is weight-bearing).

Walking with Crutches (Non-weight-bearing)

If Dr. Neuhaus has told you to avoid ALL weight-bearing, it is important to follow these instructions carefully. You will need sufficient upper body strength to support all your weight with just your arms and shoulders.

Begin in the tripod position — and remember, keep all your weight on your “good” (weight bearing) foot.
Advance both crutches and the affected foot/leg.
Move the “good” weight-bearing foot/leg forward (beyond the crutches).
Advance both crutches, and then the affected foot/leg.
Repeat steps #3 and #4.

Managing Chairs with Crutches

To get into and out of a chair safely:

Make sure the chair is stable and will not roll or slide and it must have arms and back support.
Stand with the backs of your legs touching the front of the seat.
Place both crutches in one hand, grasping them by the handgrips.
Hold on to the crutches (on one side) and the chair arm (on the other side) for balance and stability while lowering yourself to a seated position or raising yourself from the chair if you’re getting up.

Managing Stairs without Crutches

The safest way to go up and down stairs is to use your seat not your crutches.

To go up stairs:

Seat yourself on a low step.
Move your crutches upstairs by one of these methods:- If distance and reach allow, place the crutches at the top of the staircase.- If this isn’t possible, place crutches as far up the stairs as you can — then move them to the top as you progress up the stairs.
In the seated position, reach behind you with both arms.
Use your arms and weight-bearing foot/leg to lift yourself up one step.
Repeat this process one step at a time. (Remember to move the crutches to the top of the staircase if you haven’t already done so.)

To go down stairs:

1. Seat yourself on the top step.
2. Move your crutches downstairs by sliding them to the lowest possible point on the stairway then continue to move them down as you progress down the stairs.
3. In the seated position, reach behind you with both arms.
4. Use your arms and weight-bearing foot/leg to lift yourself down one step.
5. Repeat this process one step at a time. (Remember to move the crutches to the bottom of the staircase if you haven’t already done so.)