During the physical exam, your doctor will check for points of tenderness in your foot and ankle. The precise location of your pain can help determine its cause. He or she may move your foot into different positions, to check your range of motion. You may be asked to walk for a short distance so that your doctor can examine your gait.
Not all foot and ankle injuries require imaging. If your signs and symptoms meet certain criteria, your doctor may suggest one or more of the following imaging tests:
- X-ray. Most ankle and foot fractures can be visualized on X-ray. The technician may need to take X-rays from several different angles so that the bone images won’t overlap too much. Stress fractures often don’t show up on X-ray until the break actually starts healing.
- Bone scan. A technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to your bones, especially the parts of your bones that have been damaged. Damaged areas, including stress fractures, show up as bright spots on the resulting image.
- Computerized tomography (CT). CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body. CT scans can reveal more detail about the bone and the soft tissues that surround it, which may help your doctor determine the best treatment.
- Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your foot and ankle together. This imaging helps to show ligaments and bones and can identify fractures not seen on X-rays. These more advanced imaging studies are normally used in people whose occupations require them to be active on their feet, such as athletes.
Treatments for a broken ankle or broken foot will vary, depending on which bone has been broken and the severity of the injury.
Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), naproxen sodium (Aleve, others) or ibuprofen (Advil, Motrin IB, others).
After your bone has healed, you’ll probably need to loosen up stiff muscles and ligaments in your ankles and feet. A physical therapist can teach you exercises to improve your flexibility and strength.
Surgery and other procedures
- Reduction. If you have a displaced fracture, meaning the two ends of the fracture are not aligned, your doctor may need to manipulate the pieces back into their proper positions—a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
- Immobilization. To heal, a broken bone must be immobilized so that its ends can knit back together. In most cases, this requires a cast. Minor foot fractures may only need a removable brace, boot or shoe with a stiff sole. A fractured toe is usually taped to a neighboring toe, with a piece of gauze between them.
- Surgery. In some cases, an orthopedic surgeon may need to use pins, plates or screws to maintain proper position of your bones during healing. These materials may be removed after the fracture has healed if they are prominent or painful.