Metatarsal fractures are one of the most common traumatic foot injuries because there is very little soft tissue to protect the top of the foot. They can be caused by direct trauma or excessive rotational forces. Additional facts about metatarsal fractures:
- The junction between the base of the metatarsal and the shaft is the area which creates most problems when fractured because of the poor blood supply in that area of the bone.
- The base of the metatarsal heals slowly or may not heal at all because of poor blood supply.
- Orthopedists favor surgical fixation for a fracture at the base of the fifth metatarsal because it is prone to nonunion due to poor healing capacity. Surgery requires a small incision on the outside edge of the foot. Then a small screw is placed down the middle of the fractured bone.
- For a metatarsal fracture, a removable plastic cast is better than a plaster cast. The removable cast allows for physiotherapy treatment, which is aimed at preventing stiffness in the ankle joint. The foot will have to be in the non-weight bearing cast for 6-8 weeks.
- A metatarsal fracture is very painful and there is usually difficulty in walking. The foot is usally swollen, bruised, and tender to the touch.
- Ice therapy is very effective to help with the pain of a Metatarsal fracture, although pain medication is frequently prescribed. The Aircast Ankle & Foot Cryo/Cuff is an excellent method of simultaneously providing ice therapy and compression, which reduces foot pain and swelling.
- There is the possibility for nerve damage or temporary pressure on a nerve that may cause a “pins and needles” sensation. This should be investigated to determine treatment.
- Because of the importance of the first metatarsal for foot function, malalignment is less well tolerated than malalignment of a lesser metatarsal.
- Complications of metatarsal fractures include nonunion, malunion, delayed union, secondary osteoarthritis, and reflex sympathetic dystrophy.
There are many classifications of metatarsal fractures based on location, displacement, and type of fracture. The bottom line is that with any metatarsal fracture early diagnosis and avoidance of weight bearing are essential to prevent the complications.
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