Foot and Ankle
Our feet and ankles are being used everyday for various daily activities. Hence, injuries to the foot and ankle are very common.
The ankle is made up of 3 bones that meet at the ankle joint: the tibia (shinbone), fibula (smaller bone of the lower leg) and talus (small bone in between the tibia and fibula and the calcaneus). The ankle joint where these 3 bones meet are encased by a joint capsule, which contains synovial fluid. This synovial fluid is important as it allows for smooth movement of the joints. The ankle is surrounded by ligaments, which help to stabilise it.
The foot is a complex structure of the body, consisting of 26 bones, 33 joints, 107 ligaments, and 19 muscles. The bones can be categorised into 3 sections:
The forefoot consists of your toes (phalanges) and metatarsals
The midfoot consists of bones that make up the arch of your foot
The hindfoot consists of the heel and ankle, where the talus and the calcaneus (heel bone) are found.
Muscles, ligaments and tendons in the foot help stabilise your foot and allow for complex movement and motions. As there are many bones in the foot, fractures can occur at many locations in the foot, such as toe fractures, metatarsal fractures or calcaneus fractures. Another type of fracture that can occur in your foot is a stress fracture, which develop due to stress overtime.
WHAT IS A MIDFOOT FRACTURE?
A midfoot fracture, also known as a Lisfranc fracture, occurs when there is an injury to the ligaments and bones in the midfoot section of the foot. The midfoot section is made up of bones and ligaments that connect the metatarsals to the midfoot, and these bones make up the arch of your foot.
Do not be confused, a midfoot fracture is not the same as a sprain, even though the symptoms and causes may be very similar.
WHAT ARE THE SYMPTOMS OF A MIDFOOT FRACTURE?
Symptoms of a midfoot fracture include:
- Tenderness and swelling at the area of injury and the top of your foot
- Worsening pain when walking or standing
- Bruising at the top and bottom of the foot (bruising at the bottom of the foot is the strongest indicator of a midfoot fracture and not a sprain)
- Being unable to walk by yourself
WHAT ARE THE CAUSES AND RISK FACTORS OF A MIDFOOT FRACTURE?
Causes of a midfoot fracture include:
- Twisting your foot in a fall
- Falling from a great height
- Injuring your foot while it is flexed
WHAT IS THE DIAGNOSIS OF A MIDFOOT FRACTURE?
A history of the injury and a physical examination of the foot will be conducted by the Doctor. He will look for the location of bruising, and may check on your area of pain by gently pressing on the foot. Your doctor may also ask you to stand on your toes to see if it results in pain to your midfoot.
Imaging tests will be taken, such as x-ray, MRI scan and CT scan to find out the exact location of the fracture and if any of the ligaments are injured.
WHAT ARE THE TREATMENT OPTIONS FOR A MIDFOOT FRACTURE?
Depending on the type and severity of the injury, treatment options will vary for a midfoot fracture. Nonsurgical treatment options for a mild fracture include:
- Icing the injured area
- Resting the foot
- Crutches to support your weight when moving about
If the fracture is more severe, your foot may be put in a cast, up to 6 weeks. Should your injury not improve after these 6 weeks, surgery may be recommended. A surgical procedure called internal fixation will be carried out, which involves aligning and holding the bone fragments together with pins, screws or metal plates. The bone fragments will be held in place for healing.
Another surgical procedure that may be carried out is known as fusion. The bones of your midfoot get fused together to heal and form a single bone by removing the damaged cartilage around your joints, and the bones are held together with screws.
For treatment by surgery, the pins, screws or plates will be removed 4 to 6 months after the surgery is completed.