From the Guidelines
For acute foot injury, the initial treatment should focus on reducing pain and inflammation, with options including open-backed shoes, orthoses, accommodative padding, NSAID therapy, and physical therapy, as recommended by the American College of Foot and Ankle Surgeons 1. When managing acute foot injury, it's essential to consider the underlying cause of the pain.
- For initial treatment, consider the use of open-backed shoes, orthoses, and accommodative padding to reduce stress on the affected area.
- NSAID therapy, such as ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours), can help manage pain and inflammation.
- Physical therapy may also be beneficial in promoting recovery and preventing further injury.
- In some cases, corticosteroid injections may be considered, but it's crucial to avoid injecting the Achilles tendon to minimize the risk of rupture 1. The goal of these interventions is to reduce pain and inflammation, allowing the natural healing process to occur.
- If symptoms persist or worsen, it may be necessary to consider other diagnoses and refer the patient to a podiatric foot and ankle surgeon for further evaluation and treatment.
- In severe cases, immobilization with a cast or fixed-ankle walker-type device may be required, and surgical procedures such as resection of the prominent posterior superior aspect of the calcaneus and inflamed bursa may be necessary 1.
From the Research
Treatment for Acute Foot Injury
The treatment for acute foot injury varies depending on the type and severity of the injury.
- For diabetic patients with foot infections, empiric broad-spectrum antibiotic regimens are generally preferred, and treatment may include resection of necrotic tissue, parenteral broad-spectrum antibiotic therapy, and lower limb revascularization 2.
- For acute foot and ankle injuries, treatment methods include operative and non-operative treatment, and the choice of treatment depends on the type and severity of the injury, as well as the patient's overall health 3.
- For midfoot and forefoot injuries, treatment may include non-weight-bearing immobilization, referral to an orthopedic surgeon, and individualized treatment such as shoe and orthotic adjustments, injections, and surgical intervention 4.
- For acute trauma to the foot, imaging triage guidance is provided, including radiography, MRI, and ultrasound, and treatment may include immobilization, casting, and surgical intervention 5, 6.
Specific Treatment Methods
- For metatarsal shaft fractures, treatment includes a posterior splint and avoidance of weight-bearing activities, followed by a short leg walking cast or boot for four to six weeks 6.
- For proximal fifth metatarsal fractures, treatment depends on the location of the fracture, and may include a compressive dressing, a short leg walking boot, and progressive mobility 6.
- For great toe fractures, treatment includes a short leg walking boot or cast with toe plate for two to three weeks, followed by a rigid-sole shoe for an additional three to four weeks 6.
- For lesser toe fractures, treatment includes buddy taping and a rigid-sole shoe for four to six weeks 6.