1. Frostbite: Frostbite occurs when there is decreased blood flow and decreased heat delivery to the toes, but can also affect the fingers, nose and ears. Ice crystal formation takes place in the affected areas and depending on the severity of the injury can involved tendons, nerves, muscles or even bone. Symptoms include numbness, tingling, burning or loss of sensation to the area and color changes may be noted. Prognosis depends on the extent of the injury and determining this may takes weeks. In some cases amputation may be necessary or in less traumatic cases, increased prevention for reoccurrence is the only treatment. To prevent frostbite, make sure to take frequent hot-chocolate breaks from being out in the cold temperatures and investing in foot warmers to be placed between your socks and your boots will also be helpful!
2. Ankle Fractures: Ankle injuries, including sprains, strains and fractures are very common in the winter months as icy and snowy conditions lead to increased incidence of falls. According to Lauge-Hansen, an Ankle Fracture classification system, there are 4 main categories of ankle fractures classified by the position of the foot and the motion that takes place as the fracture occurs. The most common ankle fracture is classified as “Supination External Rotation” fracture (SER); meaning there is inward rotation of the ankle while the leg and body move in the opposite direction. In the most severe SER ankle fractures the tibia and fibula (bones of the leg) are broken and the ligaments surrounding the ankle are ruptured resulting in dislocation of the ankle joint. Patients suffering this type of injury will need surgical intervention to realign and stabilize the bones with internal hardware (pins and screws) in addition to repairing the ruptured ligaments. Be prepared for at least 6 to 8 weeks of complete immobilization. Preventing ankle fractures starts with wearing winter boots that have suitable traction on the bottom. Watch where you walk, and if it’s not necessary to leave the house during icy conditions, stay home and watch you’re favorite holiday movie!
3. Calcaneal (Heel) Fractures: Calcaneal fractures are less common than other type of the injury to the foot, but in the event that they do occur, they are severely debilitating. This type of injury is caused by a high impact vertical force that can occur after jumping out a window or more realistically, a fall from a ladder while hanging holiday decorations and lights! Calcaneal fractures present with severe pain and “Mondors Sign:” severe bruising of the heel that extends to both the medial (outside) and lateral (inside) areas of the foot. Due to mechanism of injury, patients often suffer associated injuries including spinal fractures. The treatment for Calcaneal fractures is much the same as that for Ankle fractures: surgical repair is necessary with the use of internal hardware and long periods of immobilization. Make sure that when you are hanging decorations this holiday season, you have a helper with you that can stabilize the ladder you’re climbing, preventing a fall.
As mentioned last week, taking preventative measures will decrease the incidence of injury, especially during the winter months. Consult your Podiatrist if you have any concerns or need suggestions for selecting appropriate “winter gear.” If you do experience a traumatic injury, get yourself to the Emergency Room as soon as possible, or call your Podiatrist for an emergency appointment.
