The 5 most common fractures around the foot and ankle

Fractures (broken bones) are a common and temporary debilitating injuries. With the right treatment, patients can return to their previous level of activity following the appropriate treatment. 


Orthopaedic surgeons are the doctors that specialise in the treatment of fractures. Due to the complexity and advances in the medical field, as orthopaedic specialists we tend to subspecialise and work on one particular area or joint in the body. As a foot and ankle orthopaedic consultant I frequently see and treat fractures around the foot and ankle. This area is one of the most intricate and complex in the musculoskeletal system with a total of 28 bones forming the foot. From these bones the most commonly fractured ones are the following:


Phalanx bone fractures – Phalanges are the small bones that form the toes. They top the list of foot and ankle fractures with about 45% of all foot fractures. These fractures frequently result from accidentally kicking a hard object such as the leg of a bed or a wall. Luckily the majority of these fractures will not require surgery to heal and a splint or strapping to the neighbouring toes is generally sufficient. 


Metatarsal fractures – The metatarsals are the bones that follow from the phalanges between the toes and the midfoot. They are also the second most fractured bone in the foot with an incidence of around 35%. Little toe or 5th metatarsal fractures are the most common and can occur after a direct impact or following a twisting injury of the ankle.  


Ankle fracture – The ankle is a joint formed of three bones and they can break in isolation or more commonly in conjunction. The fibula and tibia are the long bones in the shin that are part of the ankle joint. The talus is the third bone that articulates with them and is less commonly fractured. The tibia and fibula at the level of the ankle adopt the name of malleolus. Despite attracting most of the attention in social and medical forums, ankle fractures are not the most common in the foot and ankle area. Ankle fractures will cause pain and bruising in a swollen ankle and its treatment depends on the fracture type. They can frequently require surgery to fix them if unstable and can be misdiagnosed as an ankle sprain. This is why it is important that you see a doctor for a sprained ankle as it might be a more severe ankle injury instead.


Calcaneal fracture – The calcaneus is the heel bone that makes contact with the ground when walking. It can get fractured when landing heavily on your heels after a fall from a decent height. They normally follow high energy trauma such as road traffic accidents or falls from a building. Because of the high energy needed to fracture the calcaneus, often other bones are also fractured in the same setting such as vertebras in the spine or long bones in the legs. If they are non-displaced they will heal well with a period of rest and non-weight bearing with crutches. If the bone fragments are not aligned then surgery to reduce and fix them in the right place is recommended. Minimally invasive surgery of calcaneal fractures offers a multitude of advantages compared to the classic open surgery.


Talus fracture – This fracture is also known as the “aviator’s fracture” as it results from a heavy impact that drives the foot up against the ankle such as in a landing of an aeroplane. Nowadays they are much more common after road traffic accidents when the foot impacts on the pedals. The talus bone is a strong and small bone that connects the leg and the foot. The vast majority of these fractures will need surgery due to the importance of this bone and of its good healing.


Foot and ankle fractures are common and can result from sports injuries or higher energy impacts. When I was younger I fractured one of these bones in my foot and I was lucky to have a great foot and ankle specialist near me who helped me recover fully. Now as a foot and ankle surgeon I help my patients recover from similar injuries and I am able to sympathise fully while I put myself in their shoes.