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The response to the question below was authored by Marc Mitnick DPM

ballerina fracture 3 fractures of toes and 1 toe broken into now have stabbing pain in heel, 10yrs. old

My daughter broke her foot saturday (3 days ago), doctor said it is called ballerina fracture. It broke 3 toes (film shows a break on these toes similiar to a slit), and her 2nd toe from the pinky toe is broken completely into. She is taking tylenol3 for pain and ibuprophen to help with swelling. She has been handling the pain fairly well , but is now having a lot of pain that has just started in her her heel and she describes it as a stabbing pain. She will not be able to see the orthopedic surgeon for two more

days. Is the heel pain she is having now normal or should I call the doctor now about the severe heel pain she is now having? It is preventing her from sleeping. Thank you.

RESPONSE
Hi,
Obviously, without being able to examine your daughter it is hard for me to be accurate so I am only guessing here.
I have never heard of a "ballerina fracture" but I understand the concept that if you break multiple toes, that could happen in a ballerina stance.
Anyway as far as the heel pain goes I will make certain assumptions. One is that the heel looks normal; it is not swollen or discolored, or warm to touch. But, when your daughter steps down on the heel it is particularly painful.
If the heel pain did not happen at the time of the

trauma that caused the fractures in her toes, then it may be the result of her compensating in avoiding putting too much pressure on the front of her foot.
Because of the excess pressure she is putting on the heel and because of her age, the first thing that comes to mind as the source of her heel pain is a calcaneal apophysitis. This is an inflammation of the growth plate of the heel bone. In most cases it is seen in very active children, particularly those that participate in sports. From the constant running and jumping associated with sports activity, the growth plate of the heel bone becomes inflamed.
I could see the same thing happening in your daughter if she has been forced to put extra weight on her heel in order to avoid pressure on the ball of her foot, in order to protect her toes.
The diagnosis is made on the basis of the patient's history as there are no tell-tale signs that will show up on an x-ray.
If your daughter is in enough discomfort, I would recommend that you make an appointment with a foot specialist to have the foot examined.
Although an apophysitis is probably the most common cause of your daughter's pain it is not the only one and the only way to know for sure what is going on is for a doctor to examine your daughter.

Marc Mitnick DPM
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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Wonderful advice

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This is the best site for foot problem info.

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

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Florida

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a mom

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Jodi

location unknown

ballerina fracture 3 fractures of toes and 1 toe broken into now have stabbing pain in heel, 10yrs. old

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