What are bone spurs and how do they affect the feet. What causes bone spurs to develop in the feet. How are foot bone spurs diagnosed and treated. Can bone spurs in the feet be prevented.

Understanding Bone Spurs: What Are They and Where Do They Occur?

Bone spurs, also known as osteophytes, are bony growths that typically develop where bones meet. These smooth outgrowths usually measure less than a centimeter in length and form gradually over years. While bone spurs can occur anywhere in the body, they are most commonly found in the feet, hips, shoulders, knees, and spine.

In the feet, bone spurs tend to form in two primary locations:

• At the front of the heel
• In the center area at the top of the foot

It’s important to note that bone spurs themselves are painless. Pain and discomfort arise when the spur comes into contact with surrounding tissues, particularly nerves.

Recognizing the Symptoms of Foot Bone Spurs

How do you know if you have a bone spur in your foot? While the bony growth itself doesn’t cause pain, its interaction with surrounding tissues can lead to various symptoms:

• Pain when the spur touches other tissues, especially nerves
• Redness, swelling, and/or warmth in the affected area
• Stiffness or limitations in joint mobility
• Difficulty standing or performing weight-bearing activities

Are heel spurs related to plantar fasciitis? Indeed, heel spurs often come into contact with the plantar fascia, causing pain similar to that of plantar fasciitis. In fact, podiatrists frequently discover bone spurs when diagnosing plantar fasciitis, with approximately half of plantar fasciitis patients developing heel spurs.

The Root Causes of Bone Spurs in Feet

Why do bone spurs develop in the feet? Several factors contribute to their formation:

1. Age: The primary risk factor due to wear and tear over time
2. Cartilage breakdown: As cartilage deteriorates, the body creates extra bone to repair itself
3. Osteoarthritis: This chronic condition causes bone and joint degeneration
4. Excess weight: Puts additional stress on the feet
5. Improper footwear: Shoes that are too tight or lack proper support
6. High-impact activities: Regular weight-bearing exercises that stress the feet
7. Plantar fasciitis or flat feet: These conditions increase the risk of bone spur development

Diagnosing Bone Spurs: The Path to Proper Treatment

How are bone spurs in the feet diagnosed? The process typically involves:

1. Physical examination by a podiatrist
2. Diagnostic imaging tests, such as:
   • X-rays (most common)
   • MRI scans
   • CT scans

Once a bone spur is confirmed, the podiatrist can develop an appropriate treatment plan tailored to the patient’s specific needs.

Conservative Treatment Options for Foot Bone Spurs

How are bone spurs in the feet treated? In most cases, podiatrists rely on conservative treatment options before considering surgery. These may include:

• Cold compresses and ice packs after weight-bearing activities
• Orthotic inserts providing arch support (especially for heel spurs)
• Cortisone injections to reduce inflammation, stiffness, and pain
• Over-the-counter pain medications
• Physical therapy with stretching exercises, particularly before bed
• Resting the affected foot, especially after weight-bearing activities
• Using a walking boot to relieve pressure on the foot

Is surgery ever necessary for bone spurs? In rare cases where severe pain or mobility limitations persist despite conservative treatments, surgical removal of the bone spur may be considered. However, this is typically a last resort after exhausting non-invasive options.

Preventing Bone Spurs: Proactive Measures for Foot Health

Can bone spurs in the feet be prevented? While it’s not always possible to completely prevent bone spurs, several proactive measures can reduce your risk:

• Maintain a healthy weight to reduce pressure on your feet
• Wear well-fitting shoes that provide excellent support
• Choose appropriate footwear for specific activities
• Practice good foot hygiene and care
• Stretch and strengthen your feet regularly
• Address underlying foot conditions promptly

When should you start taking preventive measures? It’s never too early to adopt healthier lifestyle habits that support foot health. The sooner you begin, the better your chances of avoiding bone spurs and other foot-related issues.

The Connection Between Plantar Fasciitis and Bone Spurs

How are plantar fasciitis and bone spurs related? Plantar fasciitis is one of the most common causes of heel pain, affecting approximately 2 million patients annually. This condition occurs when the plantar fascia, a strong band of tissue supporting the foot’s arch, becomes irritated and inflamed.

The plantar fascia is a long, thin ligament that runs beneath the skin on the bottom of your foot, connecting the heel to the front of the foot and supporting the arch. It’s designed to absorb the high stresses and strains placed on our feet during various activities. However, excessive pressure can damage or tear the tissues, leading to inflammation and pain.

How do bone spurs factor into plantar fasciitis? Heel spurs often develop in conjunction with plantar fasciitis. As the body attempts to repair the damaged plantar fascia, it may create excess bone, resulting in a heel spur. This bony growth can then exacerbate the pain and discomfort associated with plantar fasciitis.

Risk Factors for Plantar Fasciitis and Associated Bone Spurs

What factors increase the likelihood of developing plantar fasciitis and related bone spurs?

• Age: More common in middle-aged and older adults
• Obesity: Excess weight puts additional stress on the plantar fascia
• Occupations that involve long periods of standing or walking
• Certain types of exercise: High-impact activities like running or dancing
• Foot mechanics: Flat feet, high arches, or abnormal walking patterns
• Tight calf muscles or Achilles tendons

Comprehensive Management of Foot Bone Spurs and Related Conditions

How should foot bone spurs and associated conditions like plantar fasciitis be managed? A comprehensive approach typically involves:

1. Accurate diagnosis through physical examination and imaging
2. Conservative treatments tailored to the individual’s needs
3. Lifestyle modifications to reduce stress on the feet
4. Regular follow-ups with a podiatrist to monitor progress
5. Patient education on proper foot care and preventive measures

When should you seek professional help for foot pain? If you experience persistent heel or foot pain, it’s crucial to consult a podiatrist. Early intervention can prevent the progression of conditions like bone spurs and plantar fasciitis, leading to better outcomes and faster relief.

The Role of Physical Therapy in Managing Foot Bone Spurs

How can physical therapy help in treating foot bone spurs? Physical therapy plays a crucial role in managing bone spurs and related conditions by:

• Improving flexibility and strength in the feet and lower legs
• Teaching proper stretching techniques to alleviate pain
• Providing guidance on appropriate exercises and activities
• Assisting with gait analysis and correction
• Recommending supportive devices or orthotics when necessary

A skilled physical therapist can develop a personalized treatment plan that addresses the specific needs and challenges associated with foot bone spurs, helping to reduce pain and improve overall foot function.

Advancements in Bone Spur Treatment: Exploring Emerging Options

What new treatments are being developed for bone spurs in the feet? While conservative treatments remain the primary approach, researchers are exploring several innovative options:

• Extracorporeal shock wave therapy (ESWT): Uses sound waves to stimulate healing
• Platelet-rich plasma (PRP) injections: Utilizes the patient’s own blood components to promote tissue repair
• Stem cell therapy: Aims to regenerate damaged tissue and reduce inflammation
• Minimally invasive surgical techniques: Offer faster recovery times compared to traditional surgery

Are these new treatments widely available? While some of these advanced treatments are becoming more accessible, their availability may vary depending on location and individual circumstances. It’s essential to discuss these options with a qualified podiatrist to determine the most appropriate course of action for your specific case.

The Importance of Proper Footwear in Managing Bone Spurs

How does footwear impact the development and management of bone spurs? Proper footwear plays a crucial role in both preventing and managing foot bone spurs:

• Provides adequate support to distribute weight evenly across the foot
• Reduces excessive pressure on specific areas of the foot
• Helps maintain proper foot alignment and arch support
• Minimizes friction and irritation that can exacerbate bone spur symptoms

What features should you look for in shoes to help with bone spurs? When selecting footwear, consider the following characteristics:

• Proper fit with adequate room in the toe box
• Good arch support tailored to your foot type
• Cushioning to absorb shock and reduce impact
• Stability features to prevent excessive foot motion
• Breathable materials to reduce moisture and friction

By choosing appropriate footwear and seeking professional guidance when needed, individuals can significantly improve their foot health and manage the challenges associated with bone spurs more effectively.

Bone Spur Treatment, Symptoms, and Prevention

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Bone SpursDr. Mikkel Jarman2023-03-02T13:47:48-07:00

Also known as osteophytes, bone spurs may occur anywhere on the body, including the feet.

Preferred Foot & Ankle Specialists

Bone spurs are bony growths that typically develop where bone meets bone. The growth is smooth and usually measures less than a centimeter in length. It takes years for a bone spur to form, one reason that age is the greatest risk factor.

Although bone spurs may form anywhere, they’re most often found in the feet, hips, shoulder, knees, and spine. When they occur in the foot, they typically form at the front of the heel or in the center area at the top of the foot.

What Are the Symptoms of Bone Spurs?

The bone spur itself is painless, which is why people often don’t realize they have one. When the patient does experience pain, it is because the spur touches other tissue, particularly nerves.

In addition to pain, patients who have a foot or heel spur may experience:

• Redness, swelling, and/or warmth at the affected area
• Stiffness or other limitations that affect joint mobility
• Difficulty standing or performing weight-bearing activities

Heel spurs often come into contact with the plantar fascia, which causes pain similar to that of plantar fasciitis. It is not uncommon for a podiatrist to discover a bone spur when diagnosing plantar fasciitis. In fact, around half of plantar fasciitis patients develop heel spurs.

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What Causes Bone Spurs?

Age is the greatest risk factor for bone spurs, whether on the heel or at the top of the foot. This is due in part to wear and tear that occurs over time, causing cartilage to break down. When that happens, your body creates extra bone in an attempt to repair itself, which may lead to bone spurs.

You’re also more likely to develop osteoarthritis as you age. This chronic condition causes the bone and joint degeneration that lead to the body creating excess bone – and the bone spur.

In addition to age, common bone spur causes include:

• Excess weight
• Shoes that are too tight
• Shoes that don’t provide proper support
• Regular weight-bearing activity that puts a lot of stress on your feet

Your risk is also greater if you have plantar fasciitis or flat feet.

Can Bone Spurs be Treated?

These days, treating bone spurs with surgery is rare. Instead, podiatrists rely on conservative treatment options. These may include:

• Cold compresses and ice packs after performing weight-bearing activities
• Orthotic inserts that offer arch support (specifically for treating heel spurs)
• Cortisone injections to help ease inflammation, stiffness, and pain
• Over-the-counter pain medications
• Physical therapy that includes stretching exercises, particularly before bed
• Resting the foot, particularly after performing weight-bearing activities
• A walking boot to help relieve pressure on the affected foot

If you experience severe pain and/or mobility limitations, you may be a candidate for surgery to remove the bone spur. However, your podiatrist should attempt conservative treatment options first.

Can You Prevent Bone Spurs?

Much depends on how early you begin practicing healthier lifestyle habits. That’s because one of the best things you can do to protect your feet from heel spurs is maintaining a healthy weight. This reduces the pressure and strain placed on your body.

It also helps to wear shoes that fit well and provide excellent support. Our article, Choosing the Right Shoe for Your Activity, is a good starting point.

Diagnosing Bone Spurs

After performing the physical exam, Dr. Jarman orders diagnostic tests of your feet. Typically, this means an x-ray, but it could also be an MRI or CT scan. If tests reveal bone spurs, the doctor begins treatment.

If you have recurrent heel or foot pain, call Preferred Foot & Ankle today at 480-497-3946.

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Plantar Fasciitis and Bone Spurs – OrthoInfo

Plantar fasciitis (fashee-EYE-tiss) is one of the most common causes of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year.

Plantar fasciitis occurs when the plantar fascia, a strong band of tissue that supports the arch of your foot, becomes irritated and inflamed.

The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot and supports the arch of your foot.

The plantar fascia is a ligament that lies beneath the skin on the bottom of your foot.

The plantar fascia is designed to absorb the high stresses and strains we place on our feet when walking, running, and doing other activities like playing sports. But, sometimes, too much pressure damages or tears the tissues. The body’s natural response to injury is inflammation, which results in the heel pain and stiffness of plantar fasciitis.

Too much pressure on the plantar fascia can damage or tear the tissues, causing heel pain. 

Risk Factors

In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:

• New or increased activity
• Repetitive high impact activity (running/dancing/sports)
• Prolonged standing on hard surfaces (especially among nurses, factory workers, and teachers)
• Anatomy (flat feet or a high arch)
• Tight calf muscles
• Obesity
• Age (plantar fasciitis is most common among people aged 40 to 60)

The most common symptoms of plantar fasciitis include:

• Pain on the bottom of the foot near the heel.
• Pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain goes away after a few minutes of walking
• Greater pain after (not during) exercise or activity.

After you describe your symptoms and discuss your concerns, your doctor will examine your foot. They will look for these signs:

• A high arch or flat foot
• An area of maximum tenderness on the bottom of your foot, just in front of your heel bone
• Limited dorsiflexion, or “up” motion, in your ankle
• The absence of symptoms from other conditions, such as insertional Achilles tendinitis, calcaneal (heel) stress fracture, or plantar nerve entrapment

Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem.

X-rays

X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis.

Heel spurs can be seen on an X-ray. A heel spur can be the result of longstanding (occurring for a long time) tension on the plantar fascia insertion (the spot on the heel bone where the plantar fascia attaches). However, most people who have bone spurs on their heels do not have heel pain. Since heel bone spurs are not the cause of plantar fasciitis, plantar fasciitis pain can be treated without removing the spur.

Heel spurs do not cause plantar fasciitis pain.

Other Imaging Tests

Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered.

An MRI scan may be used if the heel pain is not relieved by initial treatment methods or if your doctor is concerned that a different problem is causing your heel pain.

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Nonsurgical Treatment

More than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.

Rest. Decreasing or even stopping the activities that make the pain worse is the first step in reducing the pain. You may need to stop athletic activities where your feet pound on hard surfaces (for example, running, dancing, or step aerobics). Your doctor may recommend that you use a walking boot and crutches for a short period of time to allow your foot to rest.

Changing your activity. Low impact exercise, such as cycling or swimming, puts less stress on your joints and feet than walking or running.

Stretching. Plantar fasciitis is aggravated by tight muscles in your feet and calves. Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with this condition.

Calf stretch

• Calf stretch
  Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
• Plantar fascia stretch
  This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.

Ice. Rolling your foot over a cold water bottle or ice for 20 minutes is effective. This can be done 3 to 4 times a day.

Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications such as ibuprofen or naproxen reduce pain and inflammation. Using the medication for more than 1 month should be reviewed with your primary care doctor.

Physical therapy. Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on stretching your calf muscles and plantar fascia. In addition to exercises like the ones mentioned above, a physical therapy program may involve specialized ice treatments, massage, and other therapies to decrease inflammation around the plantar fascia.

Supportive shoes and orthotics. Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a large amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or insert reduces this tension and the microtrauma that occurs with every step. Soft silicone heel pads are inexpensive and work by elevating (raising) and cushioning your heel. Pre-made or custom orthotics (shoe inserts) are also helpful.

Soft heel pads can provide extra support.

Avoid shoes that do not provide support or are worn out. Make sure to replace your old athletic shoes before they wear out and no longer support your feet. 

Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to get used to, a night splint is very effective at reducing heel pain from plantar fasciitis.

Other Treatments

Your doctor may recommend the following procedures if you still have symptoms after several months of nonsurgical treatments.

Casting. Wearing a cast for a short period of time can be very helpful in the treatment of plantar fasciitis because it keeps your foot from moving, which is a better environment for healing. Since a cast is custom-molded to your foot and cannot be removed, it is often a better option than wearing a boot.

Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. It can be injected into the plantar fascia to reduce inflammation and pain. 

Your doctor may limit this treatment or avoid it altogether because steroid injections can weaken the plantar fascia and lead to a rupture (tear), which can lead to flattening of the foot and chronic pain.

Platelet-rich plasma (PRP) injections. PRP is obtained from your own blood and can be injected into the plantar fascia to promote healing. PRP injections do not have the same risk of leading to plantar fascia rupture. However, this treatment can be expensive, and more research is needed on the effectiveness of PRP injections.

Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. ESWT has not shown consistent results and, therefore, is not commonly performed.

ESWT is noninvasive, meaning it does not require a surgical incision. Because of the minimal (low) risk involved, ESWT is sometimes tried before surgery is considered.

Ultrasonic tissue repair. This is a minimally invasive treatment for patients with persistent (ongoing) plantar fasciitis. Ultrasound imaging is used to guide a probe toward the injured plantar fascia. The tip of the probe then vibrates to break up and remove damaged tissue.

Surgical Treatment

Because more than 90% of patients with plantar fasciitis recover with nonsurgical treatment, surgery is generally saved for people who have not seen improvement after 12 months of aggressive nonsurgical treatment.

Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite extensive efforts at calf stretching.

In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs.

Complication rates for gastrocnemius recession are low, but can include damage to the sural nerve and calf weakness.

Partial plantar fascia release. Often performed at the same time as a gastrocnemius recession, a partial plantar fascia release involves making an incision on the bottom or side of the heel. The surgeon identifies the plantar fascia insertion at the heel (the spot where the ligament attaches to the bone) and makes a partial cut to relieve tension in the tissue. If there is a large bone spur, it can also be removed.

Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage than open surgery.

• Complications. The most common complications of release surgery include nerve damage and not fully relieving pain.
• Recovery. A short period of protected weightbearing is recommended after surgery to allow the incision to heal.

Most patients have good results with surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after trying all nonsurgical treatments.

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Information on this topic is also available as an OrthoInfo Basics PDF Handout.

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Fracture of the foot – first aid, treatment in Moscow

Fractures of the bones of the foot are diagnosed in 10% of patients with injuries of the lower extremities. Damage to bone structures occurs when the foot is twisted, jumped, dropped, hit. If symptoms of a fracture appear, it is urgent to contact a traumatologist in order to avoid the development of complications.

Why do the bones in the foot break?

A fracture occurs when a force is applied to the bone that exceeds the elasticity of the bone structures. These may be traumatic or pathological factors.

Causes of traumatic fractures of the foot:

• vertical fall from a height, with increased fragility of the bone tissue, a fracture can occur even after jumping from a low chair;
• traffic accidents;
• excessive or abrupt rotation, dorsiflexion of the foot;
• heavy objects falling on the leg;
• foot tuck;
• blow, severe bruise.

What are pathological fractures?

Pathological fractures – a consequence of increased fragility of bone tissue. Most often, the problem occurs against the background of a violation of the metabolic processes of mineral substances due to hormonal or age-related changes.

The main pathologies that can cause a fracture of the foot:

• osteoporosis – a violation of the formation of bone tissue, the accumulation of calcium salts leads to a decrease in the strength and elasticity of bones;
• osteomyelitis – an infectious pathology in which the inflammatory process negatively affects the nutrition of the bones, which leads to their weakening;
• neoplasms in the bone marrow, bone tissue;
• genetic pathologies that are accompanied by a violation of the process of building and mineralization of bones;
• beriberi.

Certain drugs also negatively affect bone strength – hormonal agents, anticoagulants, drugs for the treatment of convulsive syndrome and oncological pathologies, lithium-based drugs, tetracycline antibiotics.

What are stress and neuropathic fractures

Injuries occur when the bones of the foot are exposed to traumatic factors of low intensity for a long time. Stress fractures of the foot are often found in dancers, professional athletes, and military recruits often have marching stress fractures.

A stress fracture can be caused by flat feet, rheumatoid arthritis, and other diseases that affect bone structures.

Neuropathic fracture of the predominantly fifth metatarsal often occurs in people with severe diabetes mellitus. Against the background of polyneuropathy, the sensitivity of the legs is disturbed, the person does not feel the blow, does not control the force of the impact.

General and specific manifestations of damage to the bones of the foot

Fracture of the bones of the foot is accompanied by sharp pain, which gradually becomes aching. The pain syndrome is caused by damage to the periosteum, which contains many nerve endings and pain receptors. The affected area swells, hematomas appear, the skin becomes cyanotic and hot, joint mobility is impaired. The crunch of bone fragments is rarely observed, since the bones of the foot are rigidly fixed by elastic structures.

Symptoms of a calcaneus fracture

When the calcaneus is fractured, the pain is severe or moderate. The heel area swells, reddens, sensitivity in the damaged area increases. Bruises, abrasions often appear around the heel, which can reach the arch of the foot. With massive swelling, blisters form 36–48 hours after the injury.

If the fracture is open, the wounds are located on the medial side. If the neurovascular bundle is damaged, severe bleeding is observed. Sometimes, due to circulatory disorders, ischemia develops, which can cause the death of the limb. If the nerve endings are damaged, the sensitivity in the heel area is reduced.

Signs of a fracture of the talus

When the talus is injured, sudden sharp pain occurs, which is more intense when the upper part of the foot is palpated. The foot and the ankle joint swell, bruises form on the inner surface of the ankle. With any movement of the ankle, the pain syndrome increases.

There is crepitus, increased sensitivity in the damaged area.

Manifestations of midfoot and forefoot fractures

The main symptom is severe pain in the forefoot that worsens with pressure. The edema may be slight or extensive with severe deformity. Often formed hematomas, abrasions.

How to recognize a stress fracture?

Signs of a stress fracture of the foot include dull, aching pain that covers the entire foot. At the initial stage, discomfort worries only during walking and physical exertion. But gradually unpleasant sensations arise even at rest. Puffiness, redness, deformation are weakly expressed.

Classification of fractures

There are different parameters for classifying fractures of the lower extremities.

When a crack is detected, an incomplete fracture is diagnosed. If the bone is completely or partially destroyed – complete. If there are wounds in the damaged area – this is an open fracture, if the integrity of the skin is not broken – closed.

Classification depending on the location of the fracture line:

• transverse – the fracture is across the bone;
• oblique – the bone breaks at an angle;
• longitudinal – the fracture line is located along the bone;
• helical – the fracture runs in a spiral;
• polyfocal – two or more large fragments are visible on the x-ray;
• comminuted – an injury in which several fragments of bone are formed;
• fragmented – diagnosed when a large number of fragments are detected;
• compression – a consequence of squeezing the bone, accompanied by deformation, flattening of the damaged bone structure;
• impacted – wedging of fragments into each other;
• detachable – a fragment is separated from the bone, most often this occurs at the points of attachment of the ligaments.

Foot fractures are intra-articular, in which, in addition to bones, cartilage, ligamentous apparatus and capsules are damaged. Often such a fracture is accompanied by other injuries of the limbs. Periarticular fractures are localized between the diaphysis and the end of the joint, often impacted. A diaphyseal is a fracture in the middle part of the bone, mainly with a displacement.

Classification of leg fractures by levels

There are three levels in the lower limb, each of which can cause damage to various bone structures.

Fracture of the femur

The group of femoral injuries includes:

• fracture of the head and neck of the femur C is most often intraarticular, occurs in elderly people with osteoporosis, often such an injury leads to disability;
• pertrochanteric and intertrochanteric fractures – intra-articular;
• diaphyseal fractures – accompanied by a strong displacement of fragments, sharp pain, swelling, the injured limb is shortened;
• hip condyle fracture – intra-articular, often diagnosed in elderly people after a blow or fall on the knee.

These are severe injuries that are accompanied by severe pain and profuse blood loss.

Fracture of the lower leg

The group of injuries to the bones of the lower leg includes:

• fractures of the condyles of the tibia – intra-articular, one or both condyles may be affected, there is swelling, hemarthrosis in the knee joint;
• diaphyseal – fractures of both bones of the lower leg, damage to the fibula and tibia, often accompanied by displacement, there is a crunch and pathological mobility of the injured limb;
• ankle fracture – may be accompanied by subluxation, ligament rupture, displacement.

Fracture of the bones of the foot

Injuries to the bones of the foot include:

1. Fractures of the tarsal bones – damage to the talus, navicular, sphenoid and cuboid bones.
2. Metatarsal fractures are the most common foot injury.
3. Finger fractures.

How to provide first aid in case of fracture of the bones of the foot

In case of fracture of the bones of the foot, it is important to provide first aid correctly and in a timely manner:

1. Call an ambulance.
2. Place the injured limb on a slight hill to avoid severe swelling. If the pain increases in an elevated position, the leg should be laid in a comfortable position.
3. Apply cold to the foot.
4. Treat wounds with an antiseptic, apply a sterile dressing.
5. Fix the limb with boards, plywood. The joint must be fixed above and below the fracture site. If pain worsens after applying a fixing bandage, the splint should be removed.
6. Take pain medication, no more than two doses.

Diagnostic methods

In case of a foot injury, it is necessary to consult a traumatologist. After examining the injured limb, taking an anamnesis and analyzing complaints, the doctor will prescribe the necessary studies to identify the location and type of fracture.

The main diagnostic method is X-ray. The picture is taken in the anteroposterior, lateral, oblique, Broden and projection, which is oriented along the canal of the talus.

X-rays are not always informative enough. A stress fracture of the foot at the initial stage is practically not visualized. Damage to the ligaments and soft tissues are not visible in the picture.

Auxiliary diagnostic methods:

1. CT scan – allows you to see even minor defects in bone structures. It is prescribed if x-rays are not informative enough, with signs of additional pathological processes in the bones, with suspicion of a stress fracture.
2. MRI – allows you to see any changes in soft tissues, nerve endings, blood vessels, ligaments. This is one of the best ways to identify a stress fracture
3. Ultrasound is one of the safest diagnostic methods. But it does not reflect the state of bone structures. Ultrasound can detect only indirect signs of a fracture, inflammation, foci of accumulation of blood or other fluid in the joint cavity.

Methods of treatment

The choice of methods of treatment depends on the type, severity and duration of the injury:

1. If a fracture is not displaced, a cast is immediately applied.
2. In case of a displaced fracture of the foot, open or closed reposition of fragments is performed under local anesthesia. Then a plaster cast is applied.
3. Skeletal traction. Assign for old injuries, when closed reposition is ineffective.
4. Osteosynthesis is a surgical method of bone fusion in severe comminuted fractures.
5. The Ilizarov apparatus is used for comminuted fractures.

Recovery period

Rehabilitologists use the following methods to restore the functions and anatomy of an injured limb:

1. Introducing various drugs into biologically active points of the feet using needles.
2. Therapeutic massage. Helps restore blood flow, reduce pain.
3. Physiotherapy.
4. Wearing an arch support for at least a year after the injury.
5. Therapeutic exercise. The specialist selects a set of exercises that will help you quickly return to a normal lifestyle, avoid lameness.
6. Application of teips. Muscles and ligaments are fixed with special tapes.
7. Pilates, yoga – exercises will help to relax, improve the elasticity of the ligaments and the mobility of the joints.
8. Diet therapy. Products are prescribed to accelerate the process of bone tissue repair.

Why are foot fractures dangerous?

In case of complicated fractures, the lack of proper treatment, there is a high probability of developing arthrosis, dysfunctions of the foot.

Any fracture requires immediate medical attention. The visit should not be postponed, because the callus begins to form very quickly. Specialists of the clinic “Miracle Doctor” in Moscow will conduct all the necessary research and select the best methods of therapy and rehabilitation for various foot fractures. Call us or use the form on the website to schedule an appointment with a traumatologist.

Q&A

Is it necessary to apply a cast in case of a fracture of the bones of the foot?

The imposition of a fixing plaster cast in case of a bone fracture is mandatory. Gypsum prevents the injured limb from moving, helps to reduce the load on the foot, and helps to fix the bones in the correct anatomical position. Gypsum is applied to the entire foot with the capture of the lower third of the lower leg. On average, it will have to be worn for 6-10 weeks, subject to the identification of complications.

When is surgery required for a broken foot?

Surgical intervention is necessary for severe displacement of bone fragments, with a large number of bone fragments. Surgery is resorted to if conservative methods are ineffective. The operation is performed under local or general anesthesia. Fragments are fixed with knitting needles, plates, screws.

What physiotherapy will help you recover faster after a fracture?

Physiotherapy is an important part of the rehabilitation period after fractures. They are prescribed already 2-5 days after the injury. In the first 10 days, procedures are carried out to eliminate pain, swelling, and muscle spasm. These are UHF, magnetotherapy, treatment with interference currents, ultraviolet irradiation, electrophoresis with anesthetics. Then procedures are prescribed that accelerate the process of formation of connective tissue and primary bone callus, help to avoid joint and muscle dysfunction. These are UHF, ultraviolet irradiation and current treatment, electrophoresis with calcium preparations. To consolidate the therapeutic effect, it is necessary to undergo physiotherapy once every six months.

Slowly consolidating fractures – symptoms of trauma, first aid and treatment, rehabilitation – Department of Traumatology NCC No. 2 (CCH RAS)

Fracture is a painful condition in which there is a violation of the integrity of the bone resulting from an injury under the influence of a damaging factor that is stronger than the strength of the bone tissue. Fractures are of two types: open and closed, with and without displacement of bone fragments. After an injury, the bones grow together until a callus is formed. This process is called fracture consolidation . Accordingly, a consolidating fracture is a fused fracture. Distinguish between fast and slow consolidation. Rapid consolidation is the complete fusion of the bones, in which a callus is formed and blood circulation is restored. Delayed consolidation is a bone union disorder with slow callus formation. As a result, the fracture can grow together incorrectly and cause a lot of inconvenience to the patient.

The main causes of injury.

There are general and local reasons due to which the process of bone tissue repair slows down. These include:

• Severe illnesses (diabetes mellitus, osteoporosis)
• Bad habits (smoking, alcohol)
• Depletion of the body
• Old age (over 60)
• Multiple fractures
• Women’s dysmenorrhea
• Entry of infection or foreign bodies into the wound
• Serious soft tissue injuries
• Circulatory disorders

Signs of slowly consolidating fractures.

Signs of delayed callus formation include:

• Unnatural mobility of bone fragments in the area of ​​damage
• Pain in the area of ​​bone injury
• X-ray shows gap between bone fragments

Diagnostics.

You can recognize the slowdown in the process of proper fusion of bone tissues in the area of ​​the fracture:

• during a clinical examination (the doctor, by bending and pressing hard on the area of ​​injury, determines whether the pain persists, whether elasticity and springiness appear at the fracture site)
• by radiography (can only be used 16-22 days after the fracture, the fracture line will be clearly visible on the x-ray, and the callus is vaguely expressed)

List of specialists to contact:

• Traumatologist-orthopedist
• Surgeon

Treatment.

With delayed bone fusion, two treatment options are possible – conservative and surgical.

• Conservative treatment is the prolongation of the immobilization of the fracture, sufficient for its union. A nonunion fracture is treated with the introduction of drugs that stimulate the process of bone formation, it is possible to inject the patient’s blood into the gap between the fragments, and to inject strengthening and tonic injections.
• If the terms of consolidation increase by more than 1.5-2 months, then the patient is prescribed surgical treatment. In the Department of Traumatology, the patient will undergo one of the necessary operations according to indications: extrafocal compression osteosynthesis, bone grafting, tunnelization according to Beck, or surgery with a sliding graft according to Khakhutov.

Rehabilitation.

To speed up the recovery of slowly growing fractures, the following is prescribed:

• Physiotherapy (calcium iontophoresis, UHF, anabolic hormones, quartz irradiation, etc.)
• Therapeutic exercise
• Mud treatment
• Taking calcium preparations in combination with zinc, folic acid, magnesium, vitamins D, C, B.