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Fractures of the Foot and Ankle


Globally, there is an increased prevalence of fractures with approximately 1 fracture occurring every 3 seconds.  East Coast Podiatry Centre sees more than a dozen foot fractures every week.

 

In Asia specifically, there are several factors which we observe to have contributed to this epidemic.

  • Increased osteoporosis rates due nutrient poor diets and a rise in eating disorders such as anorexia.
  • Increased participation in high intensity interval training. This is understandable given time restrictions imposed on working   Examples are Zumba, Circuit Training, Boxing.
  • Walking surfaces are flat and hard, often comprised of marble, cement, or asphalt.
  • Technological advances lead patients into a more sedentary lifestyle compared to an outdoor lifestyle. Bone and muscle strength deteriorates with inactivity.
  • Hot and humid weather encourages patients to wear open toe, slip-on, soft footwear such as flip flops which offer no support, leading to injuries and foot deformities.
  • Fashionistas wear sky-high heels, changing the biomechanical forces on their feet.
  • Patients ignore pain with the mindset that the pain will eventually go away. Stress forces on bone are left unaddressed.

Fractures | East Coast Podiatry

Stress fractures become common when given all of the above.  Our foot and ankle specialist in Singapore commonly see foot fractures in the clinic.  The fracture may originate from microtrauma which if left untreated becomes partial to complete stress fracture.  Stress fractures are caused by overuse and repetitive activity such as basketball, circuit training, brisk walking, running or Zumba.

 

Many patients have the mindset that since they have been doing these activities for so many years yet never experienced any pain, then there is no problem.  However, just a subtle change to your routine may result in the onset of a fracture. For example:

  • Changing to a new exercise routine involving different forces or directional changes.
  • Increasing intensity of workouts.
  • Changing environment surfaces such as treadmill to outdoors.
  • Osteoporosis weakened the bones over time.
  • Twisting or landing the foot in a different position than normal.

Lower limbs and feet are specifically vulnerable to stress fractures because of the repetitive forces inflicted on them during walking, activities and daily life. The foot and ankle may take a load of up to 300% your body weight, depending on the activity you are doing.  You do not have to be an active person to sustain a foot fracture.

Runners | East Coast Podiatry

Fractures can happen anywhere on the ankle and foot: calcaneus, cuboid, navicular, toes, etc.  The most common sites are the metatarsals, as made famous by David Beckham in International Football.  This is mostly due to the metatarsals being inherently longer and thinner than the rest of the foot bones; excessive force on these bones can cause them to fail when you come to your toe-off phase of gait.

 

Fractures present as:

  • Sharp immediate pain in the fracture location.
  • Pain can diminish with rest and recurs with activity.
  • Radiating pain may be present.
  • Throbbing pain may be present at night time.
  • Tenderness, swelling, or bruising at the site of injury.
  • Dull aching sensation.

 

Fracture cases often heal without surgical intervention, but there is approximately 4-8 weeks of down-time where patients must modify their activities and immobilise their leg using casting (fixed or removable).  X-rays may be taken for diagnosis, and clinical treatment may be undertaken to ensure full recovery.  Re-injury will lead to a longer recovery time and further complications.

 

East Coast Podiatry Centre is well-equipped to heal a fracture swiftly and effectively.  Your bones have a constant state of turnover called bone remodelling, but for this to be effective a fracture must be correctly immobilized, treated and monitored to ensure full fracture union. Delayed treatment of a fracture results in longer recovery time and a possible non-healing fracture.  This eventually results in the need for surgical repair or fixation of the bones.  We refer such cases to qualified foot and ankle surgeons.

 

Examples of fracture types in the foot and ankle

 

Metatarsal Fractures Lisfrancs Injury Phalangeal/ Toe Fracture
Jones Fracture Avulsion Fracture Pathological Fracture
Tibial / Fibular Fracture Sesamoid Injury Diabetic Osteoarthropathy
Crush Injury Tri-malleolar Fracture Talar Dome Lesion
Talar Neck Fracture Calcaneal Fracture Maisonneuve Fracture

 

Learn More…

Ankle Fracture | East Coast Podiatry