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February 8, 2012
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Broken Foot

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Medical Editor:

Lisfranc Fracture Symptoms and Treatment

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

When Napoleon led his army to disaster in the Russian winter, many of his soldiers suffered from frostbite and developed gangrene of the toes and feet. Dr. Jacques Lisfranc de St. Martin figured out the anatomy of the foot, and found that cutting through joint spaces made amputation easier. His legacy is that fractures, dislocations, and sprains that affect the junction between the upper and lower foot bones bear his name. Lisfranc injuries refer to damage to the joints where the long thin metatarsal bones of the foot meet the tarsal bones (the cuboid and cuneiforms) that make up the midfoot.

Lisfranc fractures often occur when a person steps in a hole and the toes become caught, and then the person falls forward. This torque causes the ligaments that hold the joints together to tear, the joint to become unstable, and the alignment of the bones to be lost. In car accidents or other major trauma injuries, not only can the ligaments be damaged, but when the bones break, the midfoot can dislocate. In football, the Lisfranc joint is damaged when the toe is pointed downward and another player falls on the exposed heel. Such was the fate that befell Matt Schaub of the Houston Texans in 2011, and Dwight Freeney of the Indianapolis Colts in 2007.

Broken Foot Overview

Broken bones (also called fractures) in the foot are very common. Our feet are very vulnerable to slipping and twisting. Our feet and toes lead us around when we walk and are on the receiving end of dropped objects. About one out of every 10 broken bones occurs in the foot.

The Anatomy of the Foot

  • The human foot has 26 bones.

  • Commonly, doctors divide the foot into three parts: the hindfoot, the midfoot, and the forefoot.

    • There are two bones in the hindfoot. These are the talus, which is where the foot attaches to the leg, and the calcaneus, which forms the heel.

    • Five smaller bones called the navicular, cuboid, and three cuneiform bones make up the midfoot.

    • The long part of the foot is called the forefoot and contains 19 bones. There is a metatarsal for each of the five toes; the big toe is made up of two phalanges, and the other toes each have three phalanges.

    • In addition, the foot sometimes has small pebble-like bones called sesamoid bones. These bones do not perform any necessary function and are often called accessory bones.

Picture of the Anatomy of the Foot

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Broken Foot - Treatment

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Broken Foot

Muscle Strain Overview

Muscle strain is injury to muscle as a result of strenuous activity. Almost anyone can put undue pressure on muscles during the course of normal daily activities, with sudden, quick heavy lifting, during sports, or while performing work tasks. Muscle strain is sometimes referred to as muscle pull. A severe muscle strain can result in a muscle tear. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area). A sprain, in contrast, is an injury to ligaments.

Muscle Strain Symptoms and Signs

  • Swelling, bruising or redness, or open cuts as a consequence of the injury
  • Pain at rest
  • Pain when the specific muscle or the joint in relation to that muscle is used
  • Weakness of the muscle or tendons (A sprain, in contrast, is an injury to a joint and its ligaments.)
  • ...

Read the Muscle Strain article »


Read What Your Physician is Reading on Medscape

Fracture, Foot »

Approximately 10% of all fractures occur in the 26 bones of the foot.

Read More on Medscape Reference »

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