Tarsal Fracture

Foot bones

A Tarsal fracture is a break of any of the tarsal bones in the foot. Acute fractures are caused by sudden trauma. Stress fractures are hairline breaks caused by overuse. Here we explain various Tarsal fractures and how they are treated.

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What are the Tarsal Bones?

The Tarsal bones are seven bones in the middle of the foot and consist of the Calcaneus, Cuboid, Navicular, Talus, and three Cuneiform bones. They connect to the long metatarsal foot bones.

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Acute Tarsal fractures

  • Symptoms of a tarsal fracture include sudden pain from a force or impact and difficulty bearing weight.
  • Normal function of the foot is lost and there will be tenderness over a specific area depending on which bone is broken.
  • A possible deformity in traumatic fractures may also be seen.
  • A more gradual onset of pain which is worse during weight-bearing is likely to be from a stress fracture.

Treatment of an acute Tarsal fracture

  • For a traumatic fracture, most patients will have to wear a cast for around 6 weeks, and must not put weight on the foot during this time.
  • For stress fractures, a walking boot or just crutches may be issued to reduce the weight on the foot.
  • Internal fixation surgery is possible if the bone is too unstable to heal on its own, but it is usually not recommended.

Tarsal stress fractures

Stress fractures occur gradually over time from overuse. Common injuries are:

Navicular stress fracture

A Navicular stress fracture is one of the most common stress fractures. Symptoms include:

  • A poorly localized ache in the midfoot which gets worse with exercise.
  • Pain may radiate along the inside arch of the foot.
  • Symptoms go away quickly with rest, only to return again as training resumes.
  • Tenderness may be felt when pressing into the top of the foot.

Read more on Navicular stress fracture.

Cuboid stress fracture

Stress fracture of the cuboid bone is rare. It occurs from being compressed between the Calcaneus (heel bone) and the forth and fifth metatarsal bones. It is often missed when diagnosing midfoot pain because symptoms can be vague. Stress fractures are unlikely to show up initially on X-ray. But an MRI may show a Cuboid stress fracture.

Treatment consists of non weight bearing rest for between 4 and 6 weeks, followed by a gradual return to full fitness.

Cuniform stress fracture

Cuniform stress fractures are exceptionally rare Tarsal fractures. They are caused by overuse. Treatment for a medial (on the inside) Cuniform stress fracture is non weight bearing, or partial weight bearing rest. If the middle cuniform bone is affected then it will need Surgery to fix in place in order for it to heal properly.

This article has been written with reference to the bibliography.
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