II. Exam
- See Ankle Exam
- Observe for signs of focal Trauma
- Swelling or Ecchymosis
- Deformity
- Open wounds
- Skin and nails
- Palpate bony landmarks (e.g. navicular, lis franc joint, fifth metarsal base, phalanges)
- Range of motion
- Perform active and passive range of motion
- Ambulate the patient
- Inability to walk is a red flag for Fracture
- Neurovascular exam
- Dorsalis pedis pulse, posterior tibial pulse, Capillary Refill
- Motor function and Sensation
III. Imaging
-
Foot XRay
- Obtain 3 views (AP, lateral, oblique)
- Also obtain Ankle XRay when indicated
- Consider dedicated toe xrays as needed
- Consider repeat XRay in 5 to 10 days (non-diagnostic first xray)
- CT Foot
- Consider in non-diagnostic xray, but high suspicion for occult Fracture
- MRI Foot
- Consider in complicated injuries when ligament or Tendon Injury is suspected
IV. Causes: Common Fractures
V. Causes: Uncommon Fractures
- Hindfoot Fracture
- Calcaneus Fracture (high mechanism Fracture such as fall from height)
- Talus Fracture
- Midfoot Fracture
- Cuneiform Fracture (crush injury)
- Cuboid Fracture
- Forefoot Fracture
VI. Causes: Stress Fractures
- High Risk Foot Stress Fractures
- Low Risk Foot Stress Fractures
- Calcaneus Stress Fracture
- Cuneiform Stress Fracture
- Cuboid Stress Fracture
VII. Management: Foot Fractures requiring urgent or emergent orthopedic Consultation
- Lisfranc Injury
- Tarsal Fractures (esp. displaced Fractures)
-
Compartment Syndrome
- Seen especially with Calcaneal Fracture
- Lisfranc Injury
- Open Foot Fracture
- Neurovascular compromise
VIII. References
- Feden and Kiel (2017) Crit Dec Emerg Med 31(11): 3-10
- Orman and Ramadorai in Herbert (2016) EM:Rap 16(12): 8-9
- Silver (2024) Am Fam Physician 109(2): 119-29 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Injury or Poisoning (T037) |
| ICD10 | S92.9 , S92.90 |
| SnomedCT | 15574005 |
| English | Fracture of foot, unspecified, fracture of foot (diagnosis), fracture of foot, Broken foot, Foot fracture, Unspecified fracture of foot, broken foot, fracture foot, of foot fracture, foot fracture, foot broken, foot fractures, Fracture of foot (disorder), Fracture of foot, foot; fracture, fracture; foot, Fracture of foot, NOS, Foot Fracture |
| Italian | Frattura del piede |
| Dutch | gebroken voet, fractuur; voet, voet; fractuur, Fractuur van voet, niet gespecificeerd, voetbreuk |
| French | Pied cassé, Fracture du pied |
| German | gebrochener Fuss, Fraktur des Fusses, nicht naeher bezeichnet, Fraktur des Fusses |
| Portuguese | Pé partido, Fractura do pé |
| Spanish | Pie roto, fractura del pie, fractura del pie (trastorno), fractura de pie, fractura de pie (trastorno), Fractura del pie |
| Japanese | 足骨折, ｱｼｺｯｾﾂ, ｿｸｺｯｾﾂ |
| Czech | Zlomená noha, Zlomenina nohy |
| Korean | 상세불명의 발의 골절 |
| Hungarian | Lábfejtörés, Törött lábfej |
