Dr. Kenneth S. Jung: Orthopaedics
Examining President Joe Biden’s Hairline Foot Fracture: Causes and Treatments
With the recent news of now President Joe Biden sustaining a hairline foot fracture, many people have wondered what exactly a hairline fracture of the foot means. Simply put, a hairline fracture is a common term for a crack or thin break in any bone. A hairline fracture indicates that the affected bone has maintained its overall shape, but there is a crack or thin break within the bone. On X-rays the crack appears as a thin break or “hairline”. There are various causes for a foot fracture of this type, so proper diagnosis and treatment are essential.
As with most orthopedic injury types, hairline foot fractures can be caused by various activities – from every day to the rare. In many cases, as was seemingly correct for President Biden, simple missteps, falls, or a loss of footing can cause enough impact to produce a hairline foot fracture – as can dropping something heavy on top of the foot. Car accidents can also create these types of foot fractures due to the crushing or twisting mechanisms of action. From a sports medicine perspective, hairline foot fractures can be more common in people who participate in high-impact sports that feature a lot of running or heavy footwork, such as football, gymnastics, tennis, and soccer. Long-distance runners can develop hairline foot fractures over time as well due to overuse. Finally, some bone conditions, such as osteopenia and osteoporosis, can make bones susceptible to hairline fractures.
Unlike displaced fractures, where bone fragments have moved from their original position and the bone does not maintain its overall shape, hairline fractures may be less painful – similar to a sprain. However, they still may cause an achiness in the foot, especially with walking, and should always be evaluated by a medical professional. Additional symptoms may include swelling, bruising, and difficulty bearing weight on the affected foot. The pain usually descends from a sharp sensation at the initial onset of the injury to a duller “bruised” feeling for a few weeks. The first two to four weeks are typically the most painful period.
When it comes to diagnosing hairline fractures, a trained orthopedic foot and ankle specialist can often arrive at this conclusion based on history, physical, and patient descriptions of the symptoms experienced. When imaging exams are necessary to confirm the diagnosis, the fractures are sometimes so small that they are not visible on an x-ray. To detect these types of fracture more clearly, an MRI or CT scan may be necessary.
Treating hairline foot fractures very much depends on what caused the injury. If the cause was osteoporosis or another metabolic bone condition, treatment of the underlying disease will be necessary. However, in most cases, hairline foot fractures are treated with some combination of nonsurgical options, including a prescribed period of rest and activity modification. If the fracture produces pain while walking, this might warrant crutches to relieve pressure on the injured foot. If the injury or pain is severe enough, a physician might prescribe a walking boot, typically worn for four to eight weeks. Once the boot is removed, there is commonly some stiffness or weakness in the affected area due to the lack of use during the healing process. To rehabilitate the foot and help get it properly working again, physical therapy can help immensely.
Of course, the best way to heal a fracture is to prevent it from happening in the first place. Some of the easiest things to do include wearing proper footwear for whatever activity you are participating in (i.e., don’t run while wearing flip flops). It is also vital to focus strength training activities on the feet, which can often be neglected, but the joints in your feet bear a lot of burdens, and they should be tended to accordingly.
Though hairline foot fractures usually heal with minimal intervention, it is essential not to ignore them. Playing or working through an injury that hasn’t been evaluated by a trained medical provider can be a recipe for disaster and make matters worse. So please don’t risk it and have it evaluated.