Pathologies
Foot fracture
- Navicular fracture
- Cuboid fracture
- Lisfranc injury
- Metatarsal fracture
- Toe fracture
Navicular fracture
Cause
The navicular bone, which connects with the talus and makes up part of Chopart’s joint (midtarsal joint), joining the midfoot with the heel bones, plays a crucial role in the foot’s mobility. A navicular fracture therefore affects foot movement, which means it needs to be repaired with the highest level of precision possible. It generally occurs because of a fall associated with twisting of the foot.
Treatment
A simple navicular fracture can be treated by cast immobilization followed by functional rehabilitation to limit the risk of complications. With more complex fractures, where surgical treatment is required, in most cases the bones are realigned and secured using high-precision, computer-assisted surgery to avoid negative after-effects and ensure success.
Cuboid fracture
Cause
The cuboid bone, so-named because of its cube-like shape, is in some ways the cornerstone of the foot’s lateral arch, as it is located at the junction between the front and back of the foot. Articulating with the calcaneus, the cuboid bone is the site of certain leg muscle attachments, contributing to stability and dynamic movements of the foot. Like its neighbor the navicular bone, cuboid fractures negatively affect foot movements. The cuboid is generally fractured following a fall in which the foot is sprained.
Treatment
A simple cuboid fracture can be treated by cast immobilization followed by functional rehabilitation to limit the risk of complications. With more complex fractures,when surgical treatment is required, the bones are realigned and secured using high-precision, computer-assisted surgery to avoid negative after-effects and ensure success.
Lisfranc injury and cuneiform fracture
Cause
The three cuneiform bones join the midfoot with the forefoot. At the junction of three metatarsal bones, the cuneiform bones also have an essential function in connecting the Lisfranc ligament complex, which transmits foot propulsion motions. In the majority of cases, injuries to these bones occur in the context of ligament tears. They must be considered as part of a more generalized trauma induced by high mechanical loads occurring in this area of the foot. This injury can occur during an incorrect landing motion or severe ankle sprain causing ligament tears, sometimes combined with fracture of one or multiple cuneiform bones.
Treatment
Minor injuries of the cuneiform bones and/or Lisfranc ligament complex can be treated with stabilization or complete immobilization for several weeks to allow the injured structures to heal. Severe injuries to both the cuneiform bones and the ligaments are treated surgically. In certain cases, the procedure can incorporate foot realignment to ensure stability and allow the patient to regain optimal mobility.
Metatarsal fracture
Cause
The metatarsals, which are all more than 8 cm long, are the longest bones in the foot. Because they are subjected to high mechanical loads, they are often fractured, but without an obvious injury event. The cause of the injury is most often repetitive loading in this area of the foot, making it a prime site for stress or fatigue fractures.
Treatment
In the wide majority of cases, metatarsal fractures will heal without surgical treatment. They are mainly treated with rest and by reducing the loads placed on this region of the foot. The fifth metatarsal, which is in-line with the fifth toe, is the most frequently injured metatarsal bone. Given its location on the outside of the foot, immobilization is the preferred treatment. Minimally invasive surgery can be considered if the fracture is more severe.
Toe fracture
Cause
Made up of three small bones, except for the big toe that only has two, the toes are most often fractured from the impact of a heavy object falling on them, or when a person violently bumps their toes into something.
Treatment
Toe fractures are unique in that it takes a long time for the pain to go away. In some cases, it may take up to 9 months for the injury to be forgotten. This is because the toes are heavily loaded during walking and it is difficult to implement avoidance solutions. When a fracture or crack is confirmed, an immobilization device will be used, since a cast cannot prevent this portion of the foot from moving. If a fractured toe is severely deviated, percutaneous surgery can be done to realign the bones of the affected toe. The goal is to prevent impingement with the adjacent toes after healing.
