FOOT INJURIES

MANUAL MINORS

Foot injuries are common in the emergency department due to the foot’s exposure to various activities and traumas. From an emergency medicine perspective, it is crucial to identify and manage these injuries effectively to ensure proper treatment and prevent complications.

Here is a breakdown of the main foot injuries and their management.

Category	Description
Fractures of the Foot
Metatarsal Fracture	Fractures of the long bones of the foot, caused by direct trauma or overuse. Symptoms include pain in the midfoot, swelling, bruising, and difficulty walking.
Toe Fracture	Fractures in the bones of the toes, usually from blows or falls. Symptoms include pain, swelling, and bruising in the affected toe.
Lisfranc Fracture	Fracture or dislocation at the joint between the metatarsal bones and the cuneiform bone of the foot. Symptoms include intense pain, swelling, and deformity in the midfoot.
Calcaneus Fracture	Fracture of the heel bone, usually from falls from height. Symptoms include heel pain, swelling, and difficulty walking.
Sprains and Strains
Ankle Sprain (Foot Ligaments)	Injury to the ankle and foot ligaments, typically from twisting. Symptoms include pain, swelling, and difficulty moving the foot.
Foot Muscle Strain	Injury to the muscles or tendons of the foot, often from overuse or sudden movements. Symptoms include pain, swelling, and weakness in the foot.
Direct Trauma Injuries
Contusions and Haematomas	Bruises and haematomas caused by direct blows to the foot. Symptoms include pain, swelling, and skin discolouration.
Soft Tissue Injuries	Damage to the skin, muscles, or ligaments of the foot from direct trauma. Symptoms include pain, swelling, and possible tearing of the soft tissues.
Arch Injuries
Flatfoot Syndrome	Flattening of the foot arch, causing pain and discomfort. It may be acute or chronic and related to overuse or anatomical conditions.
Heel Spur	Abnormal bone growth in the heel, often associated with plantar fasciitis. Symptoms include heel pain, especially when walking or standing.
Compression Syndromes
Compartment Syndrome of the Foot	Increased pressure within the muscle compartments of the foot, compromising blood flow. Symptoms include intense pain, swelling, and weakness in the foot.

Management Protocol

Section	Details
Initial Evaluation
Medical History and Physical Examination	Assess the injury mechanism, pain, foot function, and look for signs of complications.
Immobilisation	Use splints or devices to stabilise the foot and reduce pain.
Diagnostic Imaging
X-rays	To identify bone fractures and assess bone alignment.
CT Scan	For complex fractures and evaluation of additional damage.
MRI	To assess soft tissue injuries, such as ligaments and muscles.
Initial Treatment
Pain Management	Administer analgesics and anti-inflammatory medications.
Soft Tissue Injury Treatment	Apply ice, elevate the foot, and use compression to control swelling.
Surgical Intervention
Severe Fractures and Injuries	Surgery may be necessary to realign fractured bones or repair damaged tissues.
Rehabilitation and Follow-up
Physical Rehabilitation	To restore foot mobility and strength.
Ongoing Monitoring	Assess recovery and prevent long-term complications.
Conclusion	Each foot injury requires appropriate evaluation and treatment to ensure effective recovery and prevent long-term complications.