Overview
Fractures of the foot encompass a range of injuries affecting bones within the foot, including rare entities like sustentaculum tali fractures, which can significantly impact foot function and posture if not properly managed. 4Diagnosis
Radiographic imaging (X-rays) is essential for identifying fractures, particularly in assessing the extent and displacement of fractures like sustentaculum tali fractures. 4
CT scans may be necessary for detailed evaluation of complex fractures or to assess associated injuries.
Clinical examination to assess foot function, gait abnormalities, and presence of foot drop is crucial. 6Management
Surgical Intervention: For displaced sustentaculum tali fractures, open reduction and internal fixation (ORIF) is recommended to ensure anatomical reduction and prevent post-traumatic arthrosis. 4
Post-Operative Care: Emphasizes proper weight-bearing protocols and appropriate footwear to prevent complications such as tarsal disintegration. 6
Tendon Transfer: In cases of foot drop secondary to nerve injury or trauma, tendon transfer procedures (e.g., tibialis posterior tendon transfer) may be considered to restore function. 1Special Populations
Pediatrics: Specific considerations for foot health and development in early childhood are highlighted, emphasizing the importance of appropriate footwear and early intervention in foot health concerns. 23
Elderly: While not explicitly detailed, elderly patients may require careful assessment for osteoporosis and fall risk factors contributing to foot fractures.
Comorbidities: No specific guidance provided in the abstracts, but comorbid conditions affecting bone health (e.g., diabetes) should be considered in management plans.Key Recommendations
Perform ORIF for displaced sustentaculum tali fractures to achieve anatomical reduction and prevent post-traumatic arthrosis. (Evidence: Strong 4)
Implement rigorous post-operative protocols including controlled weight-bearing and appropriate footwear to mitigate risks of complications like tarsal disintegration. (Evidence: Moderate 6)
Consider tendon transfer surgeries for patients with foot drop to improve functional outcomes, evaluating specific techniques based on clinical need. (Evidence: Moderate 1)References
1 Stevoska S, Pisecky L, Stadler C, Gahleitner M, Klasan A, Klotz MC. Tendon transfer in foot drop: a systematic review. Archives of orthopaedic and trauma surgery 2023. link
2 Hodgson L, Hodges M, Williams AE, Nester CJ, Morrison SC. The "price-tag" of foot health in infancy and early childhood: a cross sectional survey of UK parents. European journal of pediatrics 2021. link
3 Hodgson L, Growcott C, Williams AE, Nester CJ, Morrison SC. First steps: Parent health behaviours related to children's foot health. Journal of child health care : for professionals working with children in the hospital and community 2020. link
4 Al-Ashhab ME, Elgazzar AS. Treatment for displaced sustentaculum tali fractures. Foot (Edinburgh, Scotland) 2018. link
5 . You're the Flight Surgeon. Aerospace medicine and human performance 2018. link
6 Kulkarni VN, Mehta JM. Observations of tarsal disintegration in the cases operated for foot-drop. Indian journal of leprosy 1985. link