Patient education: Heel or foot fracture (The Basics)

What is a heel or foot fracture? — A "fracture" is another word for a broken bone. The bones in the foot are also called "phalanges," "metatarsals," and "tarsals" (figure 1). The heel bone is also called the "calcaneus."

There are different types of fractures, depending on which bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

A heel or foot fracture can be caused by:

●Something falling on or striking the foot

●A sports injury or other accident

●Twisting the foot or ankle

●Falling or jumping from a height

Some heel or foot fractures are caused by overusing the foot. This is called a "stress fracture." Stress fractures are more common in people who do an activity over and over, such as running, jumping, or dancing.

What are the symptoms of a heel or foot fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms include:

●Pain, swelling, or bruising over the area

●The area looking abnormal, bent, or not the usual shape

●Not being able to move or put weight on that foot

●Numbness in the area of the broken bone

If a fracture injures a nerve, this can also cause symptoms in nearby areas. For example, a break to the lower leg bone might cause pain, tingling, or weakness in the foot or ankle.

Is there a test for a heel or foot fracture? — Yes. The doctor or nurse will ask about your symptoms, do an exam, and take an X-ray.

They might also do other imaging tests, such as a CT, MRI, or ultrasound. Imaging tests create pictures of the inside of the body.

How are heel or foot fractures treated? — Treatment depends, in part, on the type of fracture and how serious it is. The goal is to have the ends of the broken bone line up with each other so the bone can heal.

If the ends of the broken bone are already in line with each other, the doctor will put on a cast, or use a rigid shoe or walking boot to limit foot movement. This will keep the bone in the correct position so it can heal.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up:

●Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

●For more serious fractures, they might need to do surgery to put the bone back in the correct position. During surgery, the doctor puts the bones back in position. To do this, they can:

•Use screws, pins, rods, or plates to fix the bones inside the body. This is called "open fracture reduction and internal fixation."

•Put pins or screws through the skin and into the bones, and then attach the pins or screws to a bar that is outside of the skin. This is called "open fracture reduction and external fixation."

For stress fractures, the doctor might recommend limiting activities that are causing pain for a time.

How long do heel or foot fractures take to heal? — Most heel or foot fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How do I care for myself at home? — To care for yourself or your child at home:

●Follow the doctor's instructions for wearing the rigid shoe, walking boot, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down.

●Do not get a cast wet unless the doctor says that it is waterproof.

●Follow instructions for using crutches or a walker to help get around. The doctor might want you to limit how much weight you put on the foot.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Prop the injured foot on pillows, keeping it above the level of the heart. This might help lessen pain and swelling.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), and ibuprofen (sample brand names: Advil, Motrin). Adults can also take naproxen (sample brand name: Aleve).

●Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these medicines.

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

●If you smoke, try to stop. Broken bones take longer to heal if you smoke.

●Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen the foot and ankle muscles and keep the muscles and joints from getting stiff.

When should I call the doctor? — Call for advice if:

●There is less feeling or movement in your toes or foot.

●Your foot becomes swollen or starts to hurt more.

●Your skin becomes red or irritated around the cast, or redness starts to spread up your leg.

●The splint or cast feels too tight and uncomfortable, or your toes turn pale, blue, or gray.

●There is a bad smell or drainage coming from the splint or cast.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: Setting a broken bone in adults (The Basics)
Patient education: Setting a broken bone in children (The Basics)
Patient education: Surgery to fix a broken bone (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)
Patient education: How to use crutches (The Basics)
Patient education: How to use a walker (The Basics)

Patient education: Cast and splint care (Beyond the Basics)