I have a little confession to make:  I don’t watch Dancing with the Stars.  Sorry.  Never seen it.  I’ve also never seen American Idol or The Voice.  For the record, The Price is Right might be the most entertaining show on TV.  Anyway, I came across an article last week in which a contestant on Dancing was accused of faking a toe injury.  This got me thinking about an oft-heard maxim in my NYC podiatry office (pun intended- gotta read the article to get it), and that is, “It’s not broken, because I can move it.”

Toe and metatarsal fractures are very prevalent, and one of the more common complaints in any NYC podiatry office.  Generally, the mechanism of injury is either blunt force, as in knocking a poor digit into the bedpost in the middle of the night, or a twisting injury, especially in metatarsal fractures.  Of course other bones of the foot and ankle are also commonly fractured, especially the ankle, which is the most commonly injured joint in the body.  Most fractures heal very well with rest and splinting or protected weightbearing in the case of metatarsal fractures.  More complex foot fractures, such as those of the heel bone, as well as ankle fractures, may require surgical treatment.

Now that we’ve covered all that, let’s get back to the original question.  I’ve seen many types of fractures in my NYC podiatry office, and they usually follow a predictable pattern and present with a characteristic appearance, so much so that a fracture can be predicted with a pretty good degree of accuracy from the clinical appearance.  X-ray, available in the office, settles the debate.  Many patients are able to move their foot or toes, and the X-ray tells no lie – some are fractured, some are not.  A severe fracture will limit motion due to swelling and pain, but a non-displaced single fracture of most bones of the foot and ankle will allow full motion of the extremity, and this is certainly the case in stress fractures.  And some injuries that appear quite swollen and bruised, with limited motion of the extremity, are revealed to be non-fractured on X-ray.

So, if you suspect a fracture, and you can still move the foot or toes, don’t assume – even if you’re a contestant on whatever that show is.  And if one of the contestants is bouncing around on an injured digit, leave the judging to the dance competition and the podiatry to the professionals.

See you in the office.

Ernest Isaacson

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Ernest L Isaacson DPM PC
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