Problematic fractures and dislocations in the foot and ankle of athletes

Foot fractures can significantly compromise an athlete's career. Early recognition and treatment of occult fractures will reduce lay-off time and decrease the likelihood of prolonged impairment of performance. The appropriate treatment of radiographically obvious fractures will have a similar effect. The key to making an early diagnosis is the recognition of characteristic patterns on physical examination and the aggressive investigation of persistent foot pain in the athlete, whether it follows an injury or not. When a fracture is not apparent on routine radiographs, special diagnostic techniques, particularly technetium bone scanning, can effectively screen for bony injury. In the competitive athlete there is no reason to adopt a "wait-and-see" attitude. The approach in treating these injuries in athletes should be similarly definitive. If continued participation will delay healing or resolution of the symptoms, it should not be tolerated.