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Your child is crying more than usual and appears to be in pain, as this could mean that the plaster cast is rubbing in an area that is not visible. Breaking the top of the foot is a common injury for many people, especially those who regularly play sport or engage in any other practice that risks impact. There are a great many bones in the foot, but the most common fracture is to one of the metatarsals, which are connected to each toe at the top of the foot. It’s usually possible to make a full recovery from a broken foot in around eight weeks, using the services of the NHS or a private physiotherapist. How Do You Know if You Have a Broken Foot?
Very occasionally, surgery may be necessary - for example, to re-align any part of the bone that has moved out of position. Surgery is not needed for stress fractures. Follow-up care About 5-10 in 100 ankle fusions do not heal properly and need a further operation for the bones to fuse basically another ankle fusion. Minor infections in the wounds are slightly more common and normally settle after a short course of antibiotics.Fusion of major joints– NWB for up to eight to twelve weeks in plaster cast followed by FWB in a removable boot Patch “flavours” include lavender to relieve fatigue, rose for headaches and ginger for oedema. Maybe I should pour the freshly boiled water over them like teabags. Wellness or hellness? Severe deformity of the rear part of the foot such as a flat foot, high arched or “cavus” foot, a club foot or other deformity in which the ankle joint is also deformed, unstable or damaged. We can now treat some arthritic ankle joints by replacing the joint as arthritic hips and knees are replaced. This is only suitable in older patients without major foot deformities or those with rheumatoid arthritis or similar diseases. It would not be suitable if:
Your doctor is likely to suggest an X-ray of your foot if they suspect a metatarsal fracture. Acute metatarsal fractures You will be discharged with a copy of your operation note, which will have detailed post-operative instructions. It will also outline the follow-up after your surgery. Most foot blisters last between three and seven days and will normally clear up if further excessive friction is avoided. How can I prevent them? The fifth metatarsal bone is the most common metatarsal bone to be fractured in sudden (acute) injury to the foot. It may be broken at various points along its length, depending on the mechanism of injury. The other metatarsal bones can also be broken. The first, second and fifth metatarsals are the most commonly injured in sport. Several well-known footballers have had metatarsal fractures in recent years. Stress fractureThey can also occur in people who have lost nerve sensation in their feet due to neurological problems - for example, diabetes that has affected the feet. Does osteoporosis cause metatarsal fractures? Do not get your plaster cast wet. This will weaken it, and your bone will no longer be properly supported. Ankle arthroscopy (simple)– Touch weight bearing (TWB) 48 hours and then WBAT, bandage to be removed 48 hours post surgery This is an operation to “fuse” or stiffen the ankle joint. Why is it performed? Ankle fusions are performed for two main reasons:
Some fractures just need support to help healing. For example, a supportive elastic tubular bandage with a supportive, rigid shoe or boot. If needed, special shoes are available to help to immobilise the fracture and support the foot so that you are able to walk. Ankle fusion in this hospital is nearly always performed by an arthroscopic (telescope) technique. This involves inserting a telescope into the ankle. By using specialised instruments we can remove the joint surface to allow the two bones to heal together. The bones are held rigidly by two screws inserted from the inner aspect of the leg just above the ankle joint. The operation involves 4 small cuts of approximately 1cm around the ankle. Some people with foot deformities have a tight Achilles tendon (“heel cord”) or weak muscles or both. The Achilles tendon may be lengthened during surgery by making three small cuts in the calf and stretching the tendon. Sometimes additional procedures are required. How long would I be in hospital? Tendon surgery– NWB for two weeks followed by weight bearing in either a removable boot or ankle brace for at least 4 weeks Your anaesthetist will discuss pain control with you in your room prior to the surgery. This will usually involve a combination of pain relieving medications and local anaesthetic injected either by your surgeon or the anaesthetist, to make the area of the operation numb. A fusion would be advised. If you have a severe foot deformity, you may be advised to have this corrected at the same time as your ankle fusion by fusing other joints and/ or breaking and realigning the foot bones. This would be discussed at the same time as your ankle fusion. We have other information leaflets giving information about major foot fusions. It is generally not possible to change a fusion to an ankle replacement later. The foot becomes too stiff for an ankle replacement to work. We often inject local anaesthetic or steroid into damaged joints, before any surgery is considered, to see if this eases the pain. For some, this removes the pain and surgery is not necessary. For others, pain relief does not last but the results of the injection help us to decide which joints to fuse. What is involved?
These will normally heal without any complications and, in time, people are able to return to their previous activities fully. You can return to your activities when you can perform them without pain. This will typically take six to twelve weeks. Movement of your foot may also be limited. Surprisingly, however, pain can settle within a few hours.
Blisters can become a more serious concern if you have diabetes as they may not heal so easily. Please see your podiatrist for further advice. What are the treatments? Do not walk on a cast unless you have been told it is safe to do so and have been given a plaster shoe. Physiotherapy. Exercises to strengthen leg muscles may improve walking problems associated with foot drop. Stretching exercises can prevent the development of stiffness in the heel. Learning to use a high stepping gait or swinging gait is an alternative approach that some people prefer. Plaster casts are made up of a bandage and a hard covering, usually plaster of paris. They allow broken bones in the arm or leg to heal by holding them in place, and usually need to stay on for between 4 and 12 weeks. Computerised tomography (CT) scanning or magnetic resonance imaging (MRI) scanning is occasionally needed.Achilles tendon debridement– Non-weight bearing (NWB) for two weeks followed by full weight bearing (FWB) in removable boot for 4 weeks Nerve stimulation. Sometimes stimulating the common peroneal nerve electrically improves foot drop. This type of treatment is usually used in people with disabilities and is sometimes called neuromuscular electrical stimulation or functional electrical stimulation. Many people with multiple sclerosis, or who have had a stroke, have had success with it. Ankle-foot orthoses (AFOs). These are specialised L-shaped ankle splints. They simply hold the foot at 90° to the lower leg so that it can't drop down. Open or closed: an open fracture is one where the skin is broken over the fracture so that there is a route of possible infection from the outside into the broken bones. This is a more serious type of fracture, with more damage to the soft tissues around it making treatment and healing more complicated. Specialist assessment is needed. If a blister does occur, do not pop it. Cut a hole in a piece of foam or felt to form a doughnut over the blister. Tape the foam or felt in place or cover with a soft gel-type dressing. Treat an open blister with mild soap and water, apply an antiseptic ointment and cover with a protective soft gel dressing to prevent infection and speed up the healing process.
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