Foot fractures March 2018 | by EMauthor Fracture of the Talus •Minor avulsion fractures can be missed unless looked for, they can be treated with tubigrip or back slab support and followed in fracture clinic •Talar dome fractures can be missed unless looked for •Major fractures through the neck and body will require open reduction •Refer all talar fractures except the avulsions to orthopaedics Fracture of calcaneus •Result from fall from height •Exclude injuries to knees, hips and spine •Request axial view •Most will need admission to assess extent and possible surgery, refer to orthopaedics Navicular fractures •Avulsion fracture of tubercle, treated with tubigrip or plaster with fracture clinic follow up •Fracture of the body, may require internal fixation, refer to orthopaedics Tarsometatarsal fracture/dislocation (LisFranc fracture/dislocation) •Serious injury with possible vascular compromise, check pedal pulse •Identify the alignment of the metatarsal bases with cuniform bones on x-ray •Will need prompt reduction, then refer to orthopaedics urgently Base of 5th metatarsal •Avulsion fractures, oLie transversely, can be treated with tubigrip unless swelling and pain is severe, then apply a back slab. oArrange fracture clinic follow up •Jones fracture oLie at more distal level oIt is much more painful and liable for non union oWill need plaster immobilisation and non weight bearing Metatarsal shaft fractures •Can cause considerable swelling of foot •Treat with below knee back slab , crutches and fracture clinic follow up •If the swelling is severe, assess for compartment syndrome and consider admission Phalangeal fractures •Displaced , reduce and apply neighbour strap, fracture clinic •Undisplaced , neighbour strap, probably no follow up needed
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