Skip to main content

Health condition · Clinically reviewed

A broken foot, from the calcaneus to the 5th metatarsal - and everything in between.

Not one injury but a family of them. The bone that broke, and how, decides whether you leave in a boot, a cast or an operating theatre.

Jump to treatment
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a UK-registered clinician before publication.

  • 02

    Sourced from guidance

    Checked against BOAST, NICE and peer-reviewed orthopaedic sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK foot and ankle practice - Ottawa foot rules, Lisfranc awareness and Jones fracture fixation.

Key facts

A broken foot at a glance.

The essentials, in plain English - which bone, why it matters, and how UK foot and ankle teams treat it.

  • What it is

    A fracture of any bone in the foot other than the ankle or toes - hindfoot (calcaneus, talus), midfoot (navicular, cuboid, cuneiforms, Lisfranc) or forefoot (metatarsals).

  • Calcaneal fracture

    Usually a fall from height - Sanders classification for intra-articular patterns and a strong link with thoracolumbar spinal fractures.

  • Talar fracture

    High-energy injury with a real risk of avascular necrosis in displaced neck fractures - Hawkins classification guides prognosis.

  • Lisfranc injury

    Tarsometatarsal joint disruption - subtle and often missed. Plantar ecchymosis and first to second metatarsal diastasis are the clues.

  • 5th metatarsal

    Three different fractures with three different plans - tuberosity avulsion, Jones fracture and dancer’s spiral shaft fracture.

  • Stress fracture

    Insidious activity-related pain in a runner or dancer - often the 2nd or 3rd metatarsal, navicular or calcaneus. Consider RED-S and bone health.

Why this guide matters

The bone that broke sets the plan.

Not every broken foot means an operation - but some absolutely do. The three points below shape everything else on this page.

  • Mechanism tells the story

    A fall from height points to calcaneal or talar injury; a twisting inversion to a 5th metatarsal fracture; insidious pain to a stress fracture.

  • Some fractures are easy to miss

    Lisfranc and navicular stress fractures look normal on standard X-rays. Weight-bearing views, CT or MRI are often the answer.

  • Getting it right prevents arthritis

    Restoring the joint surface in calcaneal, talar and Lisfranc injuries reduces the risk of post-traumatic arthritis and long-term pain.

How the diagnosis is made

From the injury to a clear plan.

The steps a UK emergency department or foot and ankle team will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and mechanism

    Fall from height (calcaneal, talar), twisting injury (Lisfranc, 5th MT), or insidious activity pain (stress fracture) each point to different bones.

  2. 02

    Assessing

    Foot exam and Ottawa rules

    Bony tenderness at the navicular or base of the 5th metatarsal, or inability to weight-bear four steps, means X-ray.

  3. 03

    Assessing

    Neurovascular and skin check

    Assess pulses, sensation and skin integrity - open fractures, compartment syndrome and threatened skin need urgent orthopaedic input.

  4. 04

    Confirming

    X-ray - AP, lateral, oblique

    The starting point for every suspected foot fracture. Weight-bearing views are essential to unmask a subtle Lisfranc injury.

  5. 05

    Confirming

    CT for complex fractures

    Calcaneal, talar and Lisfranc injuries almost always need CT for pattern definition and preoperative planning.

  6. 06

    Preparing

    MRI for stress or occult injury

    The best test for stress fractures, occult navicular injury, Lisfranc ligament disruption and early avascular necrosis of the talus.

  7. 07

    Preparing

    Spine imaging if calcaneal

    Around one in ten calcaneal fractures come with a thoracolumbar burst fracture - image the spine before mobilising.

Typical timeline: from ED assessment to a definitive plan within 24 to 72 hours.

Symptoms

What a broken foot actually feels like.

The pattern of pain, bruising and mechanism narrows the diagnosis before the first X-ray. Some clues, like plantar ecchymosis, are diagnostic on their own.

  • Pain and swelling

    Immediate, focal pain and swelling over the injured bone - often with visible bruising within hours.

  • Inability to weight-bear

    Cannot take four steps unaided - one of the Ottawa foot rule criteria for X-ray.

  • Bruising and deformity

    Obvious deformity suggests displacement - a heel that looks widened and shortened is classic for a calcaneal fracture.

  • Plantar ecchymosis

    Bruising on the sole of the midfoot is pathognomonic for a Lisfranc injury and must not be dismissed.

  • High-energy mechanism

    A fall from height or road traffic collision points to hindfoot injury - always examine the whole limb and the spine.

  • Low-energy twist

    A simple inversion injury with pain at the base of the little toe is often a 5th metatarsal fracture.

  • Insidious activity pain

    A runner or dancer with weeks of gradual midfoot or forefoot pain that worsens with load suggests a stress fracture.

  • Red flag - open or vascular injury

    Any break in the skin over the fracture, or a cold, pulseless foot, is a surgical emergency.

Treatment

How a broken foot is treated in the UK.

Boots and casts for most metatarsal fractures - and specialist foot and ankle surgery for displaced hindfoot, midfoot and Lisfranc injuries.

  • Supportive boot and WBAT

    Air-cast walker boot with weight-bearing as tolerated - the workhorse for 2nd to 4th metatarsal and tuberosity avulsion fractures.

  • Below-knee cast, NWB

    Six to eight weeks of non-weight-bearing plaster - used for navicular stress fractures and selected talar and 5th metatarsal fractures.

  • ORIF - open reduction

    Open reduction and internal fixation with plates and screws for displaced 1st metatarsal, calcaneal and talar fractures.

  • Percutaneous fixation

    Minimally invasive screws or wires for selected calcaneal patterns and Lisfranc injuries to protect the soft tissue envelope.

  • Intramedullary screw

    The definitive fix for a Jones fracture in an athlete or where non-union risk is high - fast return to load.

  • Lisfranc reconstruction

    Anatomic reduction with screws or plates, or primary arthrodesis for high-energy or delayed presentations - specialist foot and ankle care.

  • Stress fracture rehabilitation

    Relative rest, protected weight-bearing and, crucially, treatment of the underlying driver - low BMD, amenorrhoea, vitamin D or RED-S.

  • Physio and orthotics

    Structured physiotherapy, gait retraining and custom orthotics protect the healing foot and reduce the risk of malunion pain.

A note on rehabilitation and complications

Recovery from a foot fracture is a multidisciplinary effort - orthopaedic surgeon, physiotherapist and podiatrist working together. The complications to watch for are malunion, non-union, avascular necrosis of the talus, post-traumatic osteoarthritis (sometimes needing subtalar or midfoot fusion), complex regional pain syndrome, stiffness and wound problems. Early physiotherapy, orthotics and a structured return-to-activity programme reduce all of these.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your emergency department team or foot and ankle surgeon knows your imaging and history and can tell you which parts apply to you. If in doubt, get seen.

  • British Orthopaedic Association Standards for Trauma (BOAST). Open fractures and foot and ankle guidance.

  • NICE NG38. Fractures (complex): assessment and management.

  • NICE CG124. Fractures (non-complex): assessment and management.

  • Royal College of Emergency Medicine. Ottawa ankle and foot rules.

  • British Orthopaedic Foot and Ankle Society (BOFAS). Lisfranc and calcaneal fracture standards.

Red flags

When a broken foot needs urgent attention.

Most foot fractures are urgent but not emergencies. These are the ones that are - and the missed diagnoses that cause long-term harm if ignored.

  • Open fracture

    Any wound over the fracture is a surgical emergency - IV antibiotics, tetanus cover and orthopaedic referral within the hour.

  • Compartment syndrome of the foot

    Disproportionate pain, tense swelling, pain on passive toe extension or paraesthesia after a crush or calcaneal injury - urgent surgical review.

  • Threatened skin - talar or calcaneal

    Tented, blanched skin over a displaced hindfoot fracture will necrose without urgent reduction.

  • Missed Lisfranc injury

    A midfoot sprain that will not settle, with plantar bruising or pain on the tarsometatarsal joint - image with weight-bearing views or CT.

  • Associated spinal fracture

    Around 10% of calcaneal fractures from a fall have a thoracolumbar burst fracture - image the spine before mobilising.

  • Cold, pulseless foot

    Vascular compromise after a hindfoot injury needs immediate reduction and vascular input.

  • Stress fracture in an amenorrhoeic athlete

    A stress fracture with menstrual disturbance, low body weight or restrictive eating points to RED-S - needs medical as well as orthopaedic care.

  • Progressive deformity

    A collapsing arch or worsening deformity in the weeks after injury suggests malunion or missed Lisfranc disruption.

  • Non-union pain at six months

    Persistent, load-related pain at a fracture site months on warrants CT and a specialist opinion.

Living with it

A healing foot, with a clear path back.

Four things that make the biggest difference week to week - respecting the boot, doing the physio, feeding the bone and knowing when to escalate.

A quiet reminder

Bone heals on its own schedule.

You cannot rush it. You can, though, support it with the boot, the physio and the nutrition it needs.

  1. 01 Protect

    Respect the boot

    Weight-bear as instructed and keep the boot on for walking. Coming out early is the commonest cause of delayed healing.

  2. 02 Rebuild

    Physio matters

    Structured rehabilitation restores calf strength, ankle motion and confidence - and prevents a stiff, painful foot.

  3. 03 Bone health

    Fuel the recovery

    Adequate calories, protein, calcium and vitamin D support bone healing - a DEXA scan is worth considering after a stress fracture.

  4. 04 Escalate

    Don’t settle for chronic pain

    Pain that will not settle, or a foot that feels unstable, deserves a specialist foot and ankle opinion - late Lisfranc and malunion are treatable.

Frequently asked

Everything we get asked about a broken foot.

Quick answers on Jones fractures, Lisfranc injuries, healing times and when surgery is needed.

  • What is a broken foot?

    A fracture of any bone in the foot other than the ankle or toes. That covers the hindfoot (calcaneus and talus), midfoot (navicular, cuboid, cuneiforms and the Lisfranc joint) and forefoot (metatarsals). Each has a different mechanism, imaging need and treatment plan.

  • How is a broken foot diagnosed?

    History and examination first, then X-rays in three views (AP, lateral and oblique). Weight-bearing views help unmask a Lisfranc injury. CT is used for calcaneal, talar and complex midfoot fractures, and MRI is the best test for stress fractures and occult injury.

  • What is a Jones fracture and why does it matter?

    A fracture at the metadiaphyseal junction of the 5th metatarsal, about 1.5 cm distal to the tuberosity. The blood supply in that zone is poor, so non-union is common. Athletes and active people are usually offered an intramedullary screw for a faster, more reliable recovery.

  • Why are Lisfranc injuries so often missed?

    The bruising can be subtle, standard X-rays can look normal, and the pain is easy to write off as a bad sprain. Plantar ecchymosis, tenderness at the tarsometatarsal joint and any diastasis between the first and second metatarsals on a weight-bearing X-ray should trigger further imaging and specialist review.

  • Do all broken feet need surgery?

    No. Many 2nd to 4th metatarsal fractures and 5th metatarsal tuberosity avulsions do well in a supportive boot with weight-bearing as tolerated. Displaced calcaneal, talar, 1st metatarsal and Lisfranc injuries usually need surgery to restore alignment and joint congruity.

  • How long does a broken foot take to heal?

    Most simple metatarsal fractures unite in six to eight weeks. Hindfoot and midfoot fractures take longer - three to six months to full function is typical after calcaneal, talar or Lisfranc surgery, with physiotherapy running alongside.

Related content

Keep reading.

Pulse Healthcare concierge

Send us your enquiry

A concierge service for UK private healthcare. We match you with the best vetted clinics and consultants in our network - they then contact you directly.

So we can match you to the right clinician close to you.

We reply to every enquiry within 24 hours (Mon–Fri). Confidential - your details are never shared outside our vetted consultant network.