One often pictures elderly patients sustaining foot fractures falling from a standing height or less due to decreased visual, auditory or proprioceptive input, loss of strength, an inability to recognize and avoid hazardous situations, or for medical reasons such as syncope, cerebral vascular accidents, arrhythmias, or as a side effect of medications. 1–3 However, the current elderly population is healthier, more mobile and much more active than previous generations. Although many exceed the national guidelines of moderate activity for at least 30 minutes per day, 4 there are still sizeable numbers of patients who fail to meet these recommendations. Given these variable levels of activity and physiology, one can expect injuries to range from simple toe fractures to severe foot trauma. 5–7