The 26 Review
- What is a Metatarsal Fracture A break or hairline crack to one or more of the metatarsal bones in the foot
- Causes Due to repeated stress on the bones of the foot or direct trauma
- Symptoms Pain, swelling, and difficulty walking
- Diagnosis Physical examination, X-rays, MRI
- Treatment Rest, ice, walking boot, surgery
Let’s take a closer look…
The metatarsals are the bones that make up the midfoot. These bones are named by numbers, beginning from the medial side outward (the big toe). They are called the first metatarsal, second metatarsal, third metatarsal, fourth metatarsal, and the fifth metatarsal and generally, the first metatarsal is the strongest of the group. These bones are located between the phalanges of the toes and the tarsal bone. A metatarsal fracture or foot fracture is a break or thin, hairline crack to one or more of the metatarsal bones. Foot fractures of the second to fourth metatarsal bones usually heal well on their own, with rest, elevation, and bracing. Generally, when the first and fifth metatarsal bones are fractured, they require surgery, but X-rays are used to determine if conservative measures can heal these injuries. Treatment for a foot fracture depends on how bad the fracture is and where the fracture is on the bone. Seeking the professional opinion of a podiatrist can help make sure the metatarsal fracture heals properly.
Metatarsal bones can fracture and break in many different ways. Most commonly, podiatrists observe fractures occurring from repeated stress on the bones. Repetitive motions like twisting, jumping, running, and turning can all cause a fracture. For the metatarsal bones to fully break, there would need to be a major or direct trauma such as a car crash, a heavy object falling on the bones, or getting the foot caught in something as the body continues to move forward. Typically, dancers and long distance runners battle this injury the most due to overuse of the metatarsal bones. Additionally, stepping in a hole or off a curb can cause a sudden twisting motion of the foot, which can result in a common 5th metatarsal fracture, commonly referred to as a Jones fracture.
There are a few common symptoms that are indicative of a foot fracture. Those symptoms include swelling, intense pain, and difficulty walking. Swelling is oftentimes severe for those who haven’t elevated the foot. In conjunction, there usually is a point of tenderness where the fracture has occurred. If any or all those symptoms occur, it is highly advised to contact your medical professional.
If you or someone you know has a metatarsal fracture due to a crush or twisting injury, the pain will likely be great enough to make you seek out immediate medical attention. The diagnosis for this ailment can be performed through physical examination and X-rays. However, a patient’s symptoms will lead most medical professionals to only perform an X-ray, as soon as possible.
As mentioned previously, the severity of one’s foot fracture and the type of bone injured will determine the treatment given to patients. In cases where the bone does not pierce through the skin, an emergency room provider will typically provide a splint, crutches, and prescribe pain medications, while they advise the patient to follow up with their podiatrist or orthopedic surgeon. In all cases of a foot fracture, patients should elevate the foot as much as possible within the first week, as well as apply ice to help decrease swelling and pain. Most metatarsal fractures can be treated through conservative treatment and patience alone. By wearing a stiff soled boot, walking boot, or a cast, pressure will be alleviated from the injured area. The amount of pressure one can put on their foot will depend on which bone(s) are broken. If using conservative measures, the broken bones will heal over a 6-8 week period. Some fractures do require and benefit from surgery. Those fractures include when the bone has pierced through the skin and any fractures that are so separated, they wouldn’t heal correctly. In cases where the first or fifth metatarsals have been fractured, surgery will most likely be needed. In surgery, the bones will be realigned and held in place with screws and metal plates. Non-surgical treatment plans can heal a majority of foot fractures, but it is incredibly important to speak with your podiatrist to discuss the advantages and disadvantages of both operative and non-operative treatments.