What Is a Midfoot Fracture? And What Should I Do About Them?

by | Sep 12, 2018

Toe bone connected to the foot bone Foot bone connected to the heel bone Heel bone connected to the ankle bone … “Dem Bones” might be a classic children’s song, but clearly the songwriter took some liberties with the anatomy! In fact, feet are highly complex structures with 26 bones each. (For those of you counting at home, the folk tune only mentions three of them—and we’re not really sure what “foot bone” is supposed to mean.) When we take a closer look at the bones of the feet, doctors often separate them into three different regional categories—hindfoot, midfoot, and forefoot. And of those three regions, the midfoot is the one that most everyday people know the least about. Unfortunately, it’s also a region that can develop frustrating, painful injuries and fractures if you aren’t careful—and sometimes even when you are. This blog will be taking a closer look at midfoot fractures, but before we begin, let’s do a quick anatomy lesson.

A Quick Anatomy Lesson: What Is the Midfoot and Why Is It Important?

Let’s go back to those three regions of the foot.
  • The hindfoot includes just two bones—the calcaneus and talus. Your calcaneus is your heel bone. The talus, commonly known as the “ankle bone,” sits just above it. Pretty straightforward.
  • The forefoot refers to the area around the ball of the foot and the toes. That means your phalanges (the toes themselves) and five long metatarsal bones that connect with the base of each toe.
The midfoot roughly corresponds to the arch of the foot. But it doesn’t look “orderly” on an X-ray like the metatarsals do. In fact, it kind of looks like a weird “clump” of five weirdly shaped bones all jumbled together. If you didn’t know any better, you might think they looked like a pile of strange rocks! In fact, even their names indicate how strange they might seem compared to other bones. The cuboid, for example, is called that because it’s shaped kind of like a cube. And the navicular bone comes from the Latin word for “little ship,” because it looks sort of like a boat. The midfoot bones may not look like much, but they do have an important role to play in keeping your feet healthy and pain free. The midfoot bones give structure and support to your arch, which is basically the shock absorber for your body. They allow your arch to flex ever so slightly to help dissipate the shock of impact forces, while still remaining sturdy enough to prevent collapse. They also enable the smooth transfer of forces generated by your calf muscles all the way to the front of the feet. wrapped foot

What Is a Midfoot Fracture?

While the bones of the midfoot aren’t exactly the easiest-to-injure part of your body, serious fractures of the midfoot complex aren’t that rare either—and when they do occur, they can put you in serious pain. Most midfoot fractures result from a single traumatic impact that twists the middle part of the foot—car accident, falling off a ladder or down the stairs, contact sports, etc. However, it doesn’t have to be a huge collision. A low-energy tumble from stepping on an uneven surface could just as easily be responsible. Often several different injuries occur at once. Often the ligaments along the top of the foot above the midfoot bones will be sprained and torn. Individual bones may be dislocated as well as broken. Cartilage within the joint complex is usually damaged as well. Although there may be a clean crack through one or more midfoot bones, many midfoot fractures are classified as avulsion fractures, meaning a small piece of bone breaks off and gets pulled away from the rest of the bone. Midfoot fractures can vary significantly in severity. Common symptoms include:
  • Swelling and pain, particularly along the top of the foot above the arch
  • Bruising and/or blistering on both the top and bottom of the arch
  • More serious midfoot fractures may make bearing weight extremely painful, if not impossible

What Do I Do If I Suffer a Midfoot Fracture?

Your best course of action really depends on the seriousness of your symptoms. If you’re only experiencing a minor amount of pain and tenderness that isn’t preventing you from going about your normal daily tasks, use RICE therapy for up to a week. That stands for rest, ice, compression and elevation. However, if you’re taking the time to read this blog, we’re guessing your pain is a little more severe than “minor.” And for that, you really need to try to avoid putting weight on your foot and see us as soon as you can. Although it’s possible you may not need extensive treatment, better safe than sorry. On the less severe side of this spectrum—no dislocations, no displaced fractures, no completely ruptured ligaments—nonsurgical treatments can usually provide the relief you need. In most cases, this means immobilizing the foot in a cast or non-weight-bearing boot for around six weeks. More serious midfoot injuries, unfortunately, often require some form of surgical realignment or repair. Once the injury has healed, proper rehabilitation will be critical in order to restore full function and mobility. We’ll also very likely fit you for custom orthotics that you can wear once you’re cleared for weight bearing. Your custom orthotics replace the regular insoles in your shoes and will give your arches the extra support and shock absorption assistance they need to fulfill their role without pain and injury again. Although midfoot injuries certainly aren’t fun—and often require a recovery period lasting several weeks to several months—the real takeaway is that you can return to full health as long as you seek prompt treatment and follow your doctor’s instructions carefully. If you suspect you’ve suffered a midfoot injury or fracture, please get off your feet immediately, grab an ice pack, then grab a phone and schedule an appointment to see us as soon as you can. We will do everything in our power to get you back on your feet, good as new, as quickly as possible! To schedule, please call (801) 269-9939 today.

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