Breaking your foot from falling in high heels is a real possibility. You could also need surgery to have the bones repaired. As heel heights increase, so do foot injuries associated with them. The higher the heel and skinnier the stiletto, the more likely one is for a fall -- especially on uneven terrain.
The midfoot arch is particularly susceptible to injury when wearing high heels. Remember, the foot is not designed to function in this position, so when one trips or falls in high heels there can be excessive force placed on the midfoot, causing it to break or dislocate.
Below is an example of a dislocated midfoot. The highlighted area illustrates the malalignment. Surgery involves realigning the anatomy and using surgical screws to maintain the position.
As a reconstructive foot surgeon, I can tell you that midfoot injuries come with a lot of problems.