houston podiatrist treats breaks and fractures of the foot and ankle

Did you hurt yourself, and when you went to the emergency room , they told you that you had fractured your foot? When your son dropped the bed on his toe as he was moving it, did they they say he broke his toe? And are you wondering: is there a difference between a broken or fractured bone? Is one a more serious injury than the other? And do you need to treat them differently? Keep reading and you'll get the answers to these and other questions.

Fracture or Broken Bone: What's the Difference?

Quite simply, there is no difference between a broken or fractured bone. That's because a fracture and a broken bone are one and the same. Fracture is a word with Latin origins (fractura). It translates to broken bit or fragment. In a nutshell, all broken bones are fractures. But there are different categories of fracture. And they'll need different treatment plans, if you want your broken ankle to heal properly.

The three basic types of fractures are:  non-displaced, displaced and stress fracture. I’ll give you a little more detail on each one now.

Non-Displaced Fracture.

When a bone breaks, if the broken ends stay in contact with each other, we consider the injury a non-displaced fracture. This is one of the simpler injuries to treat. That's because, as long your bone stay in alignment, and your joint is stable, we can usually cast these fractures. (More on that in a minute.) Otherwise, we can explore other non-invasive treatments. Surgery is rarely necessary with these types of fractures.  

Displaced Fracture.

When a bone break results in a major shifting of bones, loss of alignment, or joint instability, we call it as a displaced fracture. Displaced fractures can’t heal without intervention. You'll usually need surgical repair to heal this injury.


Stress Fractures.

Stress fractures aren’t the result of a traumatic injury or fall, as other fractures usually are. Instead, stress fractures form with continual, repeated impact on your bone. Not surprisingly, runners, especially ones who train for long distances, usually suffer this type of injury. We almost never see stress outside of the bones in your legs and feet.


Non Surgical Treatment Options

After surgery, or if you don't need an operation, we'll have to take pressure off your broken ankle. And we'll also want to keep it immobile. In the old days, we always casted broken ankles. But, while that gave you a way to collect your friends' signatures, casts are itchy. They get in the way of bathing, and are a major pain.

That's why podiatrists like me are moving away from casts. Instead, we're exploring options such as removable braces or walking boots. They help you protect your healing bone, while making it easier to clean your body and perform doctor-approved rehab moves. Now, thanks to new research, we know that boots are just as effective as those old school casts.


Walking Boot or Cast: Understanding the Options 

Researchers at the University of Warwick proved that casts aren't more effective than boots. 

Researchers spent four years monitoring patients as part of the Ankle Injury Rehabilitation (AIR) Trial. They compared treatment outcomes for patients with broken ankles. One group wore casts, the other functional braces. And, at the end of the study, they found no difference in outcomes. (Results they published in The BMJ journal.)

Now, these resulst are pretty conclusive. They followed 669 patients with broken. And 334 patients got a removable brace, while 335 got casts. The brace patinets took off their boots about three times a day. (During that time, they were supposed to perform repetitions ankle exercises to protect mobility.) But the cast group couldn't do any ankle exercises. And that's because casts aren't removable.

Four months after their treatment ended, each participant filled out a questionnaire. Researchers wanted to know if their ankles hurt. Or if they were having any problems getting around. And a major focus of the questionnare related to real-life challenges. So researchers asked if patients had walking pain, or stiffness and swelling with movement. They also wanted to know if climbing stairs, running, jumping or squatting was a challenge. Or if the participants needed support to stay active.

After recording all the answers, researchers gave each participant a a score called the Olerud Molander Ankle Score (OMAS). Then, they combines each group's scores and compared outcomes.

Here's what they found. After four months, both groups had almost identical survey scores. And that was true for patients who'd had broken ankle surgery, or for those with simpler fractures.

Explaining her findins, lead author Professor Rebecca Kearney spoke to Medical Life Sciences News. She said, since casts aren't better, "It comes down to a decision on the cost of the interventions." She also suggests exploring patient preferences, which is something I always try to do. Even without new research telling me to do so!

Treating Broken Ankles in Houston, TX

If you've twisted your ankle or tripped down stairs, there's a good chance you've broken your ankle. (Especially if you notice bruising, redness, swelling or tenderness to the touch.) Remember, even if you can walk on that ankle, it could still be broken. And the only way to tell is with an X-ray.

Now, as soon as you hear X-ray, I know you're thinking about an emergency room visit. But that's not necessary. Because I can X-ray your suspected fracture in my office. And, since all I do is treat your feet, toes and ankles, I'm much more likely to notice a hairline fracture that an ER radiologist might miss.

So what should you do if you think you have a broken bone in your foot, leg or toe? Come see me right away, by making an emergency appointment! Remember: regardless of the type of fracture (remember, all breaks are fractures!) Tanglewood Foot Specialists can help. So make Dr. Andrew Schneider your first call if you suspect any type of foot fracture.

Dr. Andrew Schneider
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A podiatrist and foot surgeon in Houston, TX.