Fracture of the metatarsal bone of the foot
Content:
- Metatarsal fracture types
- Metatarsal fracture symptoms
- Metatarsal fracture causes
- Diagnostics
- Metatarsal fracture treatment
- Rehabilitation after metatarsal fracture
Metatarsal fractures are the most common type of foot injury, occurring in about 25% of cases. A person is not able to diagnose such a fracture on his own, often confusing it with a severe bruise, although in some cases, due to unbearable pain and edema, the victim immediately consults a doctor. Is plaster cast and surgery always indicated, what is the rehabilitation, and how soon will the patient be able to walk at full strength?
Metatarsal fracture types
The human foot is the most complex mechanism, consisting of 26 bones, 5 of which are tubular metatarsal bones located between the phalanges of the fingers and the tarsus. A crack or fracture of even one such bone greatly affects the ability to move, because the metatarsal bones can be compared to the levers that set the entire foot in motion.
There are the following types of metatarsal fracture:
- fractures of a traumatic nature;
- fatigue or stress fractures.
In the first case, we are talking about a fracture as a consequence of an injury. This can be a fall of a heavy object on the leg, an unsuccessful positioning of the foot with a dislocation and fracture, a fall, an accident, etc. Metatarsal fractures can be open or closed, with or without displacement. Fatigue fractures are most often diagnosed in athletes and people engaged in heavy physical labor with a strong load on the lower limbs. Usually cracks and fractures occur from systematic stress or minor, but often repeated bruises.
Metatarsal fracture symptoms
The main and first sign of a metatarsal fracture is severe pain when the foot is exerted while walking. The site of the fracture can be identified by hyperemia and swelling. If the fracture occurs after an injury (impact or fall), the person may hear a characteristic crackling sound. As a rule, such damage causes a person to limp severely, since any load (step, run) is accompanied by painful sensations.
The area of the fracture swells, and in the daytime, when the leg is vertical, the swelling is strong, and less pronounced at night. To relieve the condition of the victim in the first hours after the injury, you can apply ice to the foot or any cold object wrapped in a towel. This procedure is recommended every 1.5 hours. The duration of cooling is no more than 20 minutes, so as not to cause frostbite and to give tissues and blood vessels the opportunity to recover.
If you cannot get an appointment with a doctor in the next few hours, you can apply a bandage with an elastic bandage in such a way as to fix the foot, reduce pain and prevent further deformation. An elevated leg position can help reduce swelling and pressure in the foot. Insulate, warm, use ointments is prohibited.
Metatarsal fracture causes
Fracture of the metatarsal bones equally often affects both women and men, too active children are prone to them. The main cause of a fracture is almost always a strong systematic stress combined with a weakened bone tissue (osteoporosis). An unsuccessful landing during a jump, a fall from a height, a fall of a heavy object on the foot can lead to a fracture.
Other reasons include:
- wearing uncomfortable shoes;
- road traffic accidents;
- diseases of the skeletal system.
Diagnostics
X-rays and a thorough examination are the main methods for diagnosing a metatarsal fracture. But here it is important to find out its reasons. If it is not a shock or fall injury, the patient should be interviewed. Perhaps too intense stress, deterioration of the condition of the bones, namely, their fragility, led to the fracture.
When a fatigue crack or fracture occurs, the radiograph may be of little value. It is very difficult to see microscopic bone damage in this case. It is probably possible to diagnose a fracture only after a careful examination and questioning of the patient.
Metatarsal fracture treatment
The method of fracture treatment will depend on the type, complexity and location of the injury. Plaster cast is not always indicated, especially when it comes to an adult. If a fracture without displacement is diagnosed, it is enough to apply a splint fixing a tight bandage and exclude any load on the foot. You can only walk on crutches and keep your leg completely at rest for several weeks.
With a slight displacement of the metatarsal bone, its reduction is shown, followed by fixation with plaster. The plaster is applied for about a month.
If the displacement of bone fragments is strong, doctors decide on an operation. In some cases, bone fixation can be applied with wires, which are removed after fusion.
In difficult cases, a tissue incision is performed, a direct reduction of the bone is performed, all fragments are compared, metal screws and plates are used for fixation. During this operation, it is important not to damage the nerves and tendons. If the reduction and alignment with the fragment are performed incorrectly, the person will constantly feel pain, suffer from edema, lameness and deformity of the foot.
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Rehabilitation after metatarsal fracture
Complete fusion of the metatarsal bone after a fracture is a long process. This is due to the complex structure of the foot, poor blood circulation in the lower extremities, and difficulty maintaining rest. The performance of the foot in the same volume is restored only 3-5 weeks after the removal of the plaster.
During this period, it is important to follow the doctor's recommendations:
- bandage with elastic bandage;
- massage;
- Exercise therapy;
- physiotherapy;
- wearing special shoes or orthopedic insoles;
- moderate loads;
- proper nutrition.
What consequences can expect a patient who neglects the advice of doctors? Firstly, it is the limited mobility of the foot. Secondly, the impossibility of wearing certain types of shoes. Thirdly, the possible development of arthrosis and other bone diseases. In addition, a person may feel a dull pain that occurs periodically, especially after a long walk. That is why it is necessary to timely contact a surgeon or traumatologist for any discomfort in the foot area, especially if there has been an injury or fall.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
