Evaluation

How will my fracture be evaluated?

At the scene of the injury, first aid for foot fractures consists of dressing any wounds, treating shock, taking weight off the foot, and transferring the patient to hospital. Sometimes it is advisable to splint the foot.

In the Emergency Room the focus of the treating team is on treating pain and shock, diagnosing the foot injury accurately, making sure that there are no other significant injuries, and arranging for referral to the appropriate specialist. Many foot fractures can be treated by the Emergency Room Physician and followed by your Family Doctor, but others require referral to an orthopaedic surgeon or podiatrist.

The evaluation will include taking an account of the accident and the type of force that hurt your foot. The foot will be examined for wounds, tenderness, swelling, bruising, or any abnormality of the shape of the foot or toes. It may be helpful to compare it with the uninjured side. Many of the accidents that cause a fracture on one side also cause a less prominent but still significant injury on the other. Footwear and socks must be removed for the examination and this may require cutting off the shoe or boot to prevent further pain.

X-rays of the foot, toes, or ankle will be taken if there is a suspicion of fracture. The standard views are often sufficient but special x-rays, including stress views, can be ordered for fractures of the talus and injuries of Lisfanc’s joint.

The specialist’s assessment will repeat the history and physical examination. The patient’s general medical status, occupation, sports activity, and expectations are all important aspects which may affect the treatment plan. The surgeon will evaluate the x-rays and may order more specific views to make sure the full extent of the injury is known.

For fractures of the calcaneus, ankle bone and mid-foot a Computerized Tomography (CT) Scan may be useful. Once the anatomy of the fracture is completely understood the surgeon will discuss the treatment options with you. This discussion may take into account the exact nature of the fracture and its prognosis as well as your expectations, preferences, and general medical status.