Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The bones in the foot may be broken in many ways including direct blows,
crush injuries, falls and overuse or stress.
Initial treatment may include RICE (rest, ice, compression, elevation).
Rest may include the use of crutches to limit weight bearing.
X-rays often help make the diagnosis but bone scan or
computerized tomography (CT scan) may be needed to help visualize the injury.
Treatment of foot fractures depend upon which bone is broken but many
fractures are treated with a compression dressing, a stiff- soled shoe, and
weight bearing as tolerated.
Some foot fractures require surgery to repair the damage.
Complications of foot fractures include non-union at the fracture site,
arthritis if a joint is involved, and infection if the skin is broken.
What is the structure of the foot?
The foot is designed to withstand the considerable forces
placed on it by
walking, running, and jumping. There
are 26 bones of the foot,
connected by joints and supported by thickened ligaments to absorb the impact of movement. As well,
the joints of the foot are acted upon by muscles and tendons that allow flexing and
extending to permit walking and running to occur.
The bony anatomy can be described as follows:
The talus articulates with the
tibia (shin bone) to form the
The calcaneus or the heel
bone is attached by ligaments to the tibia to
provide stability to the ankle joint.
The midfoot consists of the navicular, the cuboid, and the three cuneiform
bones. The midfoot is where inversion and supination of the foot occurs. These
motions allow the sole of the foot to turn inwards and upwards.
The five metatarsal bones are connected to each toe.
The toe bones are called phalanges (single =
phalanx) with the great toe
having two and the other four toes having three each. These bones are named
based upon their relationship to the body:
proximal, middle and
means closest to the center of the body while distal is furthest from the
The arch of the foot is maintained by the
plantar fascia, a thick fibrous
band of tissue that runs from the calcaneus to the metatarsal, preventing the
bones of the foot from flattening.
There are places in the foot where two bones meet to form a joint. Each
joint has its own set of structures that help maintain stability.
The midfoot gets no respect. While people can relate to a stubbed toe or sprained ankle; the part of the foot that connects the two, and is responsible
for helping absorb the shock of walking, running, and jumping isn't given much
thought. Not so for the French surgeon Jacques Lisfranc de St. Martin, a surgeon
in Napolean's army. Dr. Lisfranc studied the midfoot bones, the joints where
they connected, and the ligaments that held them together. Understanding that
anatomy led to his name being attached to the classic Lisfranc fracture
dislocations that occurred when horsemen fell and their foot was trapped in the