Avulsion Styloid Process Fractures

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What Is An Avulsion Styloid Process Fracture?

An avulsion fracture differs from a regular fracture, which occurs suddenly, and a stress fracture, which develops gradually due to tiny hairline cracks. An avulsion fracture happens when the tension from a tendon or ligament attached to a bone pulls off a fragment of the bone, causing it to fracture.
 
One of the most common sites for an avulsion fracture is at the base of the fifth metatarsal—the long bone in the midfoot that connects to the fifth toe. If you run your fingers along the outside edge of your foot, you’ll feel a bump known as the styloid process, where the fracture typically occurs. This area has a lower blood supply compared to other parts of the foot, making healing and recovery slow and often painful.
outer foot pain could be characterised as avulsion styloid fracture

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Who Is At Risk Of An Avulsion Styloid Process Fracture & Why?

Anyone can sustain an avulsion fracture by accidentally twisting the foot, such as during an ankle sprain or misstepping on uneven ground or a curb. However, individuals who frequently overuse the peroneus brevis muscle—located along the outside of the leg and attaching to the styloid process—are at higher risk. When this muscle becomes tight and repeatedly pulls at its attachment, it can lead to a fracture.
 
This type of injury is particularly common in dancers, especially ballet dancers, due to the extensive time spent on the toes. Symptoms of an avulsion fracture include pain along the outer edge of the foot that may radiate up the foot and leg, swelling, bruising, and difficulty walking or wearing shoes without significant discomfort.

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Treating An Avulsion Fracture

First Steps

If you’ve just experienced pain, the initial steps are to rest, elevate your foot, apply ice to reduce swelling, and use a compression bandage if available. Non-steroidal anti-inflammatory medications, such as Nurofen, can also help alleviate swelling and pain.

See Your Podiatrist

It’s important to see your podiatrist right away. As mentioned, these fractures take longer to heal due to their location, so timely and effective treatment is crucial. Depending on your symptoms, your podiatrist may recommend using a moonboot or walker, custom foot orthotics to relieve pressure and pain, modifications to your daily footwear for optimal support, and adjustments to your activity plan. Physical therapy should only begin after significant healing has occurred.

Surgery

In some cases, surgery may be necessary depending on the severity of the fracture. If this is needed, your podiatrist will refer you to the appropriate specialist.

Healing and return to regular activity can take anywhere from six weeks to four months, or longer if complications arise.

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