Do I Have to Wear a Cast if I Have a Broken Bone?

A fracture is a partial or complete break in one or more of your bones. Which bone is broken and the severity of the injury help determine how we treat the injury. 

Some breaks are mild and only require rest and over-the-counter medications, but some are severe and require a sturdy brace or cast.

At Chicagoland Foot and Ankle, our team of board-certified foot and ankle specialists regularly treats all types of fractures, both acute and stress-related. If you suspect a fracture in your foot or ankle, come into the office to have us evaluate the injury and treat it properly.

Acute fractures

Most people break their ankles after taking a direct hit, either from contact with an object or from a fall. The most common ways ankle fractures and foot bone fractures occur are:

• Being in a car accident
• Playing sports
• Falling from a height
• Tripping and falling
• Taking a misstep and rolling the ankle

Your ankle joint contains three bones: the tibia (shinbone), fibula (lower leg bone), and talus (connects leg bones to foot bones). Ligaments, tendons, and connective tissue hold these bones together in the joint.

It’s possible to break more than one of these ankle bones at the same time. The more bones you break, the more severe the injury. Serious fractures often require surgery, and it may take several weeks to two years to fully recover from the injury.

Symptoms of a fracture include:

• Significant pain
• Swelling
• Bruising
• Difficulty walking
• Difficulty bearing weight
• Protruding bone with broken skin (open fracture, less common)

Depending on the severity of your fracture, you may or may not be able to notice an obvious deformity. 

In many cases, fractures occur beneath the skin without causing any obvious tissue damage, but if your foot or ankle is bruised or swollen and you can’t bear weight, it’s a good bet at least one bone is broken.

If your fractured bone protrudes through the skin, seek emergency medical attention as soon as possible. Loss of blood and risk of infection are two factors that make this a serious condition.

Most serious fractures require some period of immobilization, so it’s quite possible you may have to wear a cast or boot for a few weeks to a few months. You may also have to go through physical therapy once the cast comes off to rehab the foot/ankle and regain strength and mobility.

Stress fractures

A stress fracture is either a small crack in a bone or severe bruising within the bone tissue. Many stress fractures are overuse injuries, occurring over time when repetitive forces cause microscopic damage to the bone. 

The metatarsal bones of the foot are the most commonly affected because they absorb most of the shock of movement.

The force isn’t strong enough to cause an acute or complete fracture. But when a movement, especially in sports, is repeated so often that weight-bearing bones and support muscles don’t have enough time to heal between repetitions, stress fractures are the result.

Bone tissue is in a constant state of turnover — aka, remodeling. New bone develops and replaces older bone, whose materials are recycled. But if you’re too active, the older bone breaks down so rapidly that it outpaces the body's ability to repair and replace it. The bone weakens, and stress fractures can occur.

Pain from stress fractures usually develops gradually, and it’s worse when you’re doing weight-bearing activities. You also typically experience tenderness at the site of the fracture.

Stress fractures don’t generally require a cast. Instead, temporarily refrain from any high-impact activities to give the bone(s) a chance to rest. If you return too quickly to normal activity, it can delay healing and increase the risk of a complete (through the bone) fracture, which takes much longer to heal.

Stress fractures at the base of the fifth metatarsal are more difficult to treat because blood supply to this area is poor, so healing takes longer. Nonsurgical treatment relies on non-weight-bearing immobilization (cast or boot) for at least six weeks.

Do you want to learn more about fractures and their treatment? Chicagoland Foot and Ankle can help. To get started, book online or call us at any of our locations — the Mount Greenwood and Portage Park areas of Chicago, as well as Orland Park, Niles, Bartlett, and New Lenox, Illinois.