A comminuted fracture of the instep is more serious; the fact that it can result in a comminuted fracture of the instep indicates a relatively high degree of violence and, in causing a comminuted fracture, will inevitably result in damage to the soft tissues of the instep. The soft tissue of the dorsum of the foot is very thin, and severe injuries can cause the skin to break down, resulting in an open fracture. An open fracture can lead to infection of the broken end of the fracture and eventually osteomyelitis and non-union of the fracture. Once the soft tissue has been broken down this means that there may be a leakage of bone and eventually the dorsum of the foot can only be covered by means of a transfer flap. Even if the fracture heals completely, the walking function of the dorsum of the foot will be compromised.