Foot avulsion fracture  

What is this information about?

This information is about foot avulsion fracture. 

It tells you: 

• how to look after yourself when you go home from hospital with a foot avulsion fracture 
• what exercises you can do to help heal and strengthen your foot 
• what follow-up treatment you might have 
• who to contact if you need further help and support 

What is a foot avulsion fracture?

A foot avulsion fracture happens when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Tendons and ligaments are made of tough fibres and connect bones to muscles or bones to bones. 

How long is it likely to take for my injury to heal?

It usually takes 6 weeks for a foot avulsion fracture to heal. 

Do I have a fracture or a break

If you have a fracture, it means you have a broken bone. ‘Fractured bone’ and ‘broken bone’ both mean the same.  

Will smoking or vaping slow down my healing?

Yes. Smoking slows healing so if you smoke or vape try to stop or cut down. This is most important in the first 2 weeks after your injury. If you would like help to stop smoking talk to your GP or visit  Quit smoking – NHS for further information. 

What should I do if I am in pain after my foot avulsion fracture?

You may have foot pain for 3 to 6 months after your injury. If you are in pain, take your usual pain killers or pain killers given to you in the emergency department. Follow the dose instructions on the packet. If you are struggling with pain do speak to your GP or pharmacist. 

What should I do if I have a swollen foot after my foot avulsion fracture?

You may have foot swelling for 3 to 6 months after your injury, however it should be clearly improving from 4 weeks onwards, if not please contact the virtual fracture clinic.

Swelling is often worse at the end of the day. To reduce swelling that you may get soon after your injury: 

• apply cold packs (ice pack or frozen peas wrapped in a damp towel) to the sore area for up to 15 minutes every few hours. This can provide short-term pain relief.  

• try to rest your foot, especially in the first 24 to 72 hours (1 to 3 days). Raise your foot on a stool or cushions so that it is above the level of your hip. 

Can I walk after my foot avulsion fracture?

Yes. You can walk on the foot as much as is comfortable. You may find crutches help to take some of the weight off your foot so that you can walk more comfortably.  

Will I have further (follow up) appointments?

No. We do not usually follow up people with this type of injury. However, if after 6 weeks you are:  

• still experiencing a lot of pain and swelling  
• struggling to walk and move around without your boot or rigid sole shoe 

Please contact the Virtual Fracture Clinic for further advice. 

What should I do from week 1 to week 2 after my injury?

• Rest your foot for the first 24 to 72 hours (1 to 3 days). Try to raise it above the level of your hips. For example, rest it on some pillows if you are lying down or a stool if you are sitting. This will help to reduce your swelling. 
• Keep moving around and walk on the foot as much as is comfortable. If we have given you a boot or rigid sole shoe for comfort wear it when you are walking. Take it off at night or when you are resting. 
• Start doing the exercises shown below as soon as possible. Moving your foot and ankle as soon as you can after your injury helps your blood to circulate and reduces your chance of getting a Deep Vein Thrombosis (blood clot).  
• Do these exercises about 5 times a day. Start straight away, working within your pain levels. 

Exercises

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

2. With your heels together, move your toes apart to turn the foot outwards. Repeat this 10 times. Do not stretch so much that it hurts. 

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

What should I do from week 3 to week 5 after my injury?

• After two weeks try to wear you boot or rigid shoe less each day until you no longer need to wear it at all. It is usual to still have mild discomfort and swelling at this stage. This may continue for 3 to 6 months.  
• Aim to move on to doing gentle stretching exercises as shown below.  
• Slowly increase your day-to-day activity level. 

Exercises

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

2. Point the toes of your injured foot down as far as they go. Place your other foot on top and press down with it to apply some pressure. This will stretch the top of your foot. Hold for 30 seconds.

What should I do from week 6 after my injury?

It is usual to still have mild discomfort and swelling. This may continue for 3 to 6 months. Your fracture should be healed by this time.  Aim to practice balance exercise as shown below: 

Level 1: These exercises are for people who could not stand on one leg before their injury. 

1. Stand with your feet as close together as possible. Hold onto a firm support in a safe space (for example where you cannot fall onto furniture with hard edges). Hold your balance for 30 seconds.   
2. Now try removing your hand. Try to keep your balance for 30 seconds.  
3. Hold onto a firm support.  
4. Put one foot in front of the other, as close together as you can. Hold this for 30 seconds. If you can, try to let go of the support and keep your balance. 

Level 2: These exercises are for people who could stand on one leg before their injury. 

1. Hold onto a firm surface in a safe space (for example where you cannot fall onto furniture with hard edges).  Try to stand on one leg. Hold this for 30 seconds. Stop if it causes pain. When you can do this comfortably, try the next exercise.  
2. Try to stand on one leg without holding on to a support. Try to hold this for 30 seconds. When you can do this comfortably, try the next exercise.  
3. You can try these exercises with your eyes closed. Make sure you are always in a safe place with a support to hold if needed.  

What should I do if I am struggling with my boot or my rigid sole shoe?

The boot and shoe have a thicker sole than your usual shoes. This can make you feel that your legs are uneven in length.  

Make sure you wear a shoe or trainer on your uninjured foot that will support it. This will reduce stress on your other joints. If you need more advice, contact the Virtual Fracture Clinic.  

What should I do if I have diabetes?

If you have diabetes there is a greater chance that pressure on your skin over a long period could cause skin ulcers. Wearing a boot or rigid sole shoe could cause pressure on your skin. 

We can give you advice or arrange for your foot to be checked in the plaster room if you need that. 

What other things can the Virtual Fracture Clinic help me with?

Please contact the Virtual Fracture Clinic if you:

• are concerned about your symptoms 
• are struggling to return to exercise or your usual activities 
• would like further information or support after you have read this information. 

When can I start driving?

You can return to driving when: 

• you are no longer using your boot or rigid sole shoe 
• you can walk comfortably  
• you can safely deal with all emergency situations without being in pain or hesitating. For example, you must be able to stop the car quickly and in full control and safely avoid obstacles 
• you are covered by your insurance company. 

How can I get a certificate to say that I am fit to work?

You can get a fitness for work statement from the Virtual Fracture Clinic. 

What do I do with my ankle boot, rigid sole shoe, and crutches when I no longer need them?

How do I contact the Virtual Fracture Clinic?