Avulsion fracture to your midfoot

Patient Information Leaflet

Healing

• This is a small flake fracture that is treated like a sprain.
• This normally takes about 6 weeks to heal.
• Smoking will slow down your healing.
• We would advise that you stop smoking while your fracture heals.
• Talk to your GP or go to www.smokefree.nhs.uk for more information.

Pain and swelling

• You may have foot pain and swelling for 3-6 months after your injury.
• Swelling is often worse at the end of the day.
• Taking pain medication, elevating your foot and using ice or cold packs will help.
• More information about this can be found below.

Walking and your boot

• The boot protects your ankle and will make you more comfortable.
• Wear the boot when you are standing and walking for the first two weeks.
• You can take it off at night and at rest.
• Please inform us if you are diabetic as you may need a special boot.
• You are allowed to put weight through your foot.
• You may find it easier to use crutches in the early stages.

Exercises

• It is important to start exercises as soon as possible.
• Instructions are on the next page.

Follow up

• A follow up appointment is not normally needed for this injury.
• If you still have significant pain and swelling after three months, then please contact the Virtual Fracture Clinic team.

Any questions?

• Please contact the Virtual Fracture Clinic team if:
  • You are worried about your symptoms.
  • You are finding it hard to follow your rehabilitation plan.
  • You have pain in a different part of your body from your injury.

Caring for your injury: Week 1-2

Remember to wear your boot whenever standing and walking for the first two weeks.

• You can remove the boot when resting and at night.
• Wear a long sock in your boot.

Using a cold pack will help with your pain and swelling.

• You can use an ice pack or bag of frozen peas wrapped in a damp towel.
• Put this on your ankle for up to 15 minutes every few hours.
• Make sure the ice isn’t in direct contact with your skin.

Try to rest your foot

• Moving your ankle and foot early is important.
• It helps your blood flow and lowers the risk of getting a blood clot in your leg.

Exercises

• Do these exercises three to four times a day.
• Start straight away.
• You do not need to push into the pain.

1. Make gentle circles with your foot in one direction and then the other direction. Repeat this 10 times.

2. With your heels together, move your toes apart to turn the foot outwards. Repeat this 10 times. Do this movement gently within comfort.

3. Point your foot up and down. Repeat this 10 times.

Caring for your injury: Week 2-6

It is now two weeks since your injury and you can start to wean out of your boot.

• Stop using it around your own home first and continue wearing it for longer distances.
• You should aim to be fully weaned out of your boot by six weeks post injury at the latest.

It is normal to still have mild discomfort and swelling.

• This may continue for three to six months.

Activity and Exercise

• Keep doing your exercises until you have full movement in your foot.
• Gradually increase your level of activity.
• You must avoid impact activity for three months. This includes running, jumping and dancing.

Stretches

1. Point your toes down as far as they go, place your other foot on top and apply some pressure. This will stretch the top of your foot. Hold for 30 seconds.

2. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of the calf. Hold for 30 seconds.

Frequently Asked Questions

I am struggling with my boot. What do I do?

• The boot has a thicker sole and this can make you feel uneven.
• Make sure you wear a supportive shoe or trainer on your uninjured foot.
• This will reduce stress on other joints.
• If you need more advice contact the Virtual Fracture Clinic.

I am diabetic, does this change things?

• If you are diabetic, please contact us to discuss your boot.
• This is particularly important if you have problems with your skin or sensation.
• We may provide you with a specialist diabetic boot.

When can I start driving?

• You can return to driving when:
  • You are no longer using your boot
  • You can walk comfortably
  • You can perform an emergency stop pain free
  • Always test your ability to drive in a safe environment first.

How can I get a certificate for work?

• You can get a fitness for work statement from your GP.

What do I do with my boot and crutches when I no longer need them?

• We cannot use the boots again, so please do not return them to the hospital.
• You can return your crutches to the Fracture Clinic or A&E.

With thanks to Brighton and Sussex University Hospitals NHS Trust for kindly sharing their information sheets with us with full permission to use contents and images.

Contact our service

The Virtual Fracture Clinic
Call us on 020 7288 3310 (Monday to Friday 9am to 5pm)
or email whh-tr.fracturevirtualclinic@nhs.net