(516) 869-3300 Manhasset
(631) 427-3678 Huntington
(516) 544-1731 Great Neck
(718) 639-0499 Maspeth
(516) 681-8866 Plainview
By Dr Tyler Miranda
August 30, 2019
Category: Foot Care
Tags: Fractures   and Nutcrackers   Sprains  
Injuries to the outside of the foot and ankle are very common and wide ranging in severity. Ankle sprains are by far the most common injury to this area of the body, registering roughly 3 million incidents every year. Most lateral foot and ankle injuries only involve soft tissue but in some cases there can be an injury to one or more bones. The fibula, talus, cuboid, and 5th metatarsal are all possible sites of bone injury. 
When an injury occurs an important piece of information a doctor will ask for is called the 'mechanism of injury' which describes the direction the foot and ankle moved or twisted, the position of the foot, and what activity was being performed at the time of injury. Sometimes patients will be able to describe in meticulous detail the mechanism of injury while other times patients will say "Doc it happened so fast I cant remember." Luckily the team at Advanced podiatry can use a careful physical exam, Xrays, and diagnostic ultrasound to investigate the injury. To evaluate the injury in real time we have an on-site C-arm flouroscopy to provide pinpoint diagnosis - this imaging tool lets the doctor and patient see the bony injury on the screen and also assess the motion of the bone at the same time.
The 5th metatarsal bone is particularly susceptible to compromise during a lateral foot trauma. Patients will come into the office limping, describing a mechanism of injury sometimes similar to an ankle sprain but with pain further down from the ankle along the outside of the foot. The 5th metatarsal bone can sustain multiple types of injuries. The most well known is a Jones fracture, a horizontal fracture of the bone near the middle of its shaft. Another type of injury is an avulsion fracture. This is were the tendon that pulls on the bone is stretched too quickly and removes part of the bone as it tears away from its insertion. These injuries can be treated with immobilization and/or surgical repair depending on their severity. 
 

Jones Fracture
 

5th Metatarsal Avulsion Fracture

Nutcracker Fracture of Cuboid

 

 
The cuboid is a less commonly fractures bone. When a fracture does happen it is important that it is identified and treated as soon as possible. Sometimes these fractures are not easily visible on conventional X-rays and will require C-arm flouroscopy or CT scan for an accurate assessment. One type of cuboid injury is known as the Nutcracker fracture. The mechanism of injury is forced abduction of the forefoot: where the front of the foot is pushed outwards and the cuboid is crushed like a nut between the calcaneus (heel bone) and the 4th and 5th metatarsals. This injury will require time to heal in cast or CAM boot immobilization and may require surgery with internal or external fixation. 
 
The take home message here is that if you have an injury to the outside of the foot or ankle go get it checked out. If you think you simply sprained your ankle but that pain is lingering or even getting worse there may be a more serious injury present. 

Comments:






Contact Us

Please specify in the message section below which office you would like to be seen at. (Manhasset, Huntington, Plainview & Maspeth NY)

Advanced Podiatry of Manhasset at the Americana

(631) 427-3678 Huntington NY
(516) 869-3300 Manhasset NY
(516) 544-1731 Great Neck NY
(718) 639-0499 Maspeth NY
(516) 681-8866 Plainview NY

Manhasset, NY Office
Advanced Podiatry
2110 Northern Blvd.
Suite-208
Manhasset, NY 11030
(516) 869-3300

Huntington, NY Office
Advanced Podiatry
181 Main St.
Suite-207
Huntington, NY 11743
(631) 427-3678

Maspeth, NY  Office
Advanced Podiatry
70-01 Grand Ave
Maspeth, NY 11378
(718) 639-0499

Great Neck, NY Office
Advanced Podiatry
488 Great Neck Rd.
Great Neck, NY 11021
516-544-1731
*Moved to Manhasset  

Plainview, NY Office
Advanced Podiatry
875 Old Country Rd
Plainview, NY 11803
(516) 681-8866

Rosyn, NY Office
1514 Old Northern Blvd
Rosln, NY 11576
516-484-1420
*Moved to Manhasset