Phalangeal Injury (Foot)

Almost one-quarter of all bones in the human body are in the foot, which works to provide you with movement and support. Broken bones in one of the phalanges is often quite painful, but it isn’t normally disabling. Most of the time, the injury can heal without having to worry about operative treatment.

Stress fractures commonly occur in the forefoot bones extending from the toes to the middle part of the foot. They are like a tiny crack in the surface of the bone. If you suddenly increase your training regimen, train improperly or change the surface, you can end up with one of these fractures. Most of the other forms of fractures extend through the bones. They can either be displaced or stable. They are almost always overuse injuries, but can be the result of a trauma. If the fractured bone hasn’t broken through the skin, it is referred to as a closed fracture. It is rare for the fractured bone to come through the skin in the foot.

It is also possible to injure the ligaments in the foot around the phalanx, or strain the tendons around the forefoot.

Phalangeal Injury (Foot) Anatomy

Fractures occur from overusing the foot. Whenever the muscles are overly tired, they aren’t able to lessen the shock from any repeated impacts. If this happens, the muscles will end up transferring the stress onto the bones, which over a period of weeks or months can creates small stress fractures and cracks. 

One of the most common sites for fractures is in the second and the third metatarsals of the foot. These fractures are also common in the heel, the bone on the top part of the midfoot and the outer bone in the lower leg.

If you suspect a fracture, you should seek medical advice. The doctor or therapist will probably refer you for a scan such as an MRI scan, or an X-ray. MRI scans tend to be more sensitive at picking up stress fractures in the foot. Alternatively, you may be referred for a CT scan which can show up bone injuries quite well.

How to Treat a Phalangeal Injury (Foot):

1. Rest and Recover

Rest is the most common treatment option for any foot fractures. Refrain from engaging in any activities that possibly triggered the injury in the first place, as well as any activities causing pain in the fractured site for around three to four weeks. Choose an alternate activity that places less pressure on the foot, such as swimming. Slowly return to the activities that you once were able to do under the guidance of your therapist.

2. Immobilization

If the fracture is more significant resulting from a big trauma, the bones may have to be realigned and kept in an immobile state until they have time to heal. Buddy taping often works well to promote healing. Replace the tape and gauze as needed. If your toes look pale or feel numb, remove the tape and replace it.

3. Cast

A short-leg walking cast might be needed to provide the bone with the opportunity it needs to heal. Expect to spend six to eight weeks in the cast, depending on how severe the injury is. As the symptoms decline, you will be able to place weight on the leg.

Tips:

• When exercising or otherwise training, make sure to slowly increase your workout regimen. Don’t jump into something that is far more extreme than what you have been doing already.
• When walking, running or otherwise standing on the foot, try to avoid twisting the foot into a position that extends beyond normal reach.
• Ballet dancers have been known to break bones in the foot from a misstep or falling from doing a pointe position.
• Ankle twisting injuries can tear the tendons that attach to the bone, which causes a small part of the bone to tear away. Try to protect the foot at all costs.