HWN Suggests

Foot Injuries in the ED

The vast majority of foot injuries require at least basic foot radiographs for proper evaluation, and often ankle films as well. Obtain at least 3 views when possible. While the Ottawa Foot Rules are often referenced and tested on exams, these criteria can miss significant injuries. Special views can help identify certain fractures on x-rays (e.g., axial view for calcaneal fractures, Canale view for talar fractures. Stress films are useful in assessing LisFranc injuries. Some fractures are difficult to see on XRs, even with special views, so consider CT if your index of suspicion is high. Certain injuries require CTs for further characterization or surgical planning. MRI can be used in place…

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Articles of Interest

Diagnosis and Management of Common Foot Fractures

Foot fractures are among the most common foot injuries evaluated by primary care physicians. They most often involve the metatarsals and toes. Patients typically present with varying signs and symptoms, the most common being pain and trouble with ambulation. Diagnosis requires radiographic evaluation, although emerging evidence demonstrates that ultrasonography may be just as accurate.

EMRad: Can’t Miss Adult Ankle and Foot Injuries

This list is not meant to be a comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially catastrophic injuries.

Foot Injuries in the Emergency Department

The foot is divided into three regions: Hindfoot: Contains talus and calcaneus. Midfoot: Contains navicular, cuboid, and cuneiform bones. Forefoot: Contains the metatarsals, phalanges, and sesamoids. The midtarsal joints (Chopart’s joint) join the hindfoot and midfoot. The tarsometatarsal joints (Lisfranc’s joint) join the midfoot and forefoot.

Sprains, Strains, and Fractures

Injuries are the most common causes of foot and ankle sprains and fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle sprains and fractures. Basketball players are prone to ankle sprains, and runners may develop stress fractures of the ankle or foot. Gymnasts and dancers may also develop stress fractures.