Joel S. Buchalter, M.D., a clinical assistant professor of Orthopaedic Surgery at the Hospital for Joint Diseases, and co-director of the Orthopaedic Institute at Putnam Hospital Center in New York, says that alcohol seems to be often involved in high-heel injuries. “Because drinking impairs balance and coordination, stepping out to a club or a party in super high heels is just asking for trouble,” he points out. He’s seen quite a few severe ankle fractures and dislocations in which surgery, although helpful, did not make the ankle normal, and he’s witnessed increased injuries to the face and wrists from such falls.

With stilettos, the narrowness of the heel magnifies the risks. “It creates the perfect storm and a recipe for disaster,” Baumhauer says—especially when you walk across uneven ground. She points out that high-heel shoes often lack padding, so there’s not much to cushion the blow when your foot hits the floor. As a result, she sees a variety of fractures (most commonly ankle and fifth metatarsal breaks), as well as ligament tears and dislocated ankle tendons (peroneals), that require surgery. 

Still, some fashionistas think their heels aren’t high enough. There are plans afoot for nine-inch Sky Heel, to be released next year. That leaves plenty of time for you to consider these You Tube wipe-outs, if you’re still tempted to hit the stores.

Tips to keep your holidays fracture-free:

1. If you’re shopping and can’t decide between the 3 and 5 inch heels, choose the lower heel.
2. If you simply must wear super high heels, don’t drink.
3. Kick your shoes off under the table when seated.
4. Take your shoes off to dance.
5. Change into flats for your trip home.
6. When you work out, don’t forget to strengthen and stretch your ankle muscles.
7. If you’ve had a prior ankle injury, think twice before you leave the house in heels.

 —Orly Avitzur, M.D., medical adviser to Consumers Union