Foot Injury Summary


Summary of Emergent Care of Bony Foot Injuries
Fracture or Injury Type ED Imaging ED Care* (well-padded splints) Orthopedic Referral (immediate: within 24 h; early: within 2 wk) Home Care /Weightbearing Status
(NWBS RICE)
Advice on Long-Term Care and Management Special Considerations
Calcaneal, intra- and extra-articular Plain films, Boehler angle; CT for subtle findings Posterior splint Intra: immediate NWBS; RICE Possible surgery -
Extra: early
Talus fx CT Posterior splint Major: immediate NWBS; RICE Possible surgery Risk of avascular necrosis
Minor: early
Lisfranc CT Splint Displaced: ortho in ED NWBS; RICE Possible surgery Risk of compartment syndrome; arthritis
Nondisplaced: early
Navicular fx Plain films or CT Splint Nondisplaced: early NWBS; RICE Possible surgery Risk of avascular necrosis; nonunion
Displaced: immediate
Cuboid fx Plain films or CT Splint Early NWBS; RICE Comminuted; possible surgery -
Cuneiforms fx Plain films or CT Splint Early NWBS; RICE Medial; possible surgery -
Jones fx Plain films; CT for athletes Splint Early, out pt. NWBS; RICE Athletes; possible surgery -
Metatarsals fx Plain films Posterior splint Within 1 wk for a cast NWBS; RICE Likely not -
Stress fx Clinical - - Cessation of causative activity - -
Phalange fx Plain films Buddy or forefoot taping - Hard-soled shoe and weightbearing as tolerated - -
Open fractures of any kind Consider antibiotics, diphtheria-tetanus vaccine Pain control Ortho consult in ED - - -

Abbreviations:
fx = fracture;
NWBS = non-weightbearing status, Ortho = orthopedic;
RICE = rest, ice, compression, elevation.
*All patients with fractures should receive adequate analgesia