Rehabilitation

What happens as I recover?

After treatment the foot stays symptomatic for several weeks. It hurts and swells when it hangs down; bruising may be evident for some time also. Rather mysteriously, it is common for fractures of the hind-foot, ankle & mid-foot to result in bruising between the toes. Because the bones are deep inside the muscle layers the bleeding may track to distant areas rather than coming to the skin right under the broken bone.

Most foot bones show evidence of healing by six weeks post fracture. Until then it is often more comfortable to avoid bearing weight on the affect foot, so you should use crutches and keep the foot off the ground. Once the pain and swelling has settled you may be able to bear some weight, depending on the location and nature of the fracture. Take your doctor’s advice about this. If you put too much weight on the foot too soon, you risk displacing the fracture or breaking the pins or screws if you have had surgery.

Overall it takes about 18 months for fractures to heal fully. The first six weeks is the fastest; during that time a scar is formed between the fracture fragments and stiffened with calcium deposits. This achieves about 50% of the eventual strength of the healed bone. After that there is a slower process of maturation and consolidation of the healing area of the bone until it has the strength and appearance of normal bone. One can normally use your healed foot for all normal activities including sports by about three months. However, there will still be some aching and swelling continuing with use but getting better for another year or more.

Although some foot fractures are treated in a cast, brace, or special shoe, many need no support or protection. Toe fractures are often treated with buddy taping and weight bearing on the ball of the foot. You can get a shoe with a build up under the ball of the foot to keep weight off the toe(s). If some form of support is needed it may be discontinued at six weeks if the fracture shows evidence of healing.

Physical therapy may be needed to start you off walking safely on crutches. However, there is little need for it until after the bone has healed. Once you can put weight through the healing area it may be helpful to have an exercise program to recover movement, strength and endurance.

Fractures that damage weight bearing joints in the foot may cause post traumatic arthritis. The intent of treatment is to limit this possibility but if the accident crushes or scrapes off the joint surface it does not recover or re-grow. In time the joint will become painful and stiff. Much more often the results of healing of a foot fracture are very good with complete return to normal function, work and sports being the norm.