Assessment of Foot Injuries
If the mechanism of injury (e.g. a road crash) suggests that there may be other injuries, it is important to complete a full assessment to exclude other injuries. Otherwise, the assessment of a foot injury is the same as the assessment of any other trauma:
History
The mechanism of injury is of vital importance and may give valuable clues as to the diagnosis. Examples are:
- An inversion injury of the ankle may cause an ankle injury but may also cause a fracture at the base of the 5th MT
- Dropping a weight onto the foot may cause a fracture but is unlikely to cause a dislocation whereas a stubbed toe may cause either a fracture or a dislocation
- With major forces, one should expect serious injuries and some of these may be subtle on x-ray
- The past history may be significant and, in particular, diabetic neuropathy may predispose to a neuropathic arthropathy
Examination
This will consist of:
- Look – for deformity, bruising, swelling scars etc.
- Feel – for deformity, point of maximum tenderness
- Move – examine for movement at all the joints – subtalar, midtarsal, toes
- Function – can the patient walk? Examine their gait
- Test for neurovascular function
- Examine the ankle
X-rays and other investigations
If required.