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Fracture Repair: Metatarsal

The 26 Review

  • What is a Metatarsal Fracture Repair  Realignment and repair of a broken metatarsal
  • How The affected metatarsal will be realigned and stabilized with screws and/or a metal plate.
  • Why To restore proper foot function and relieve pain
  • Recommended for Individuals who are experiencing pain, swelling, and difficulty walking
  • Length of Treatment This procedure takes between 1-2 hours to complete.
  • Downtime Full recovery takes place in 8-12 weeks.

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.

Procedure Details: Pre, During & Post Surgery Expectations

Prior to surgery, it is highly advised to seek the opinion of a medical professional before swapping conservative treatments for a surgical procedure. The following instructions will most likely be provided prior to surgery to help reduce complications and improve outcomes:

  • Halt the consumption of anti-inflammatory medications a week before surgery to prevent excessive bleeding 
  • If you become sick, have a fever, or an infection, report it to your surgeon immediately 
  • Inquire about the risks and benefits from your podiatrist 
  • Stop any alcohol consumption or smoking to reduce the risk of infection 
  • Do not eat or drink 8 hours before surgery 
  • Wear loose-fitting pants and shoes
  • Set up a plan to get home post-surgery

Before surgery begins, patients will be instructed to lie on their back as anesthesia is administered. A small incision will be made near the desired metatarsal bone. Through the incision, the bone fragments will be repositioned to correct the alignment of the bone. The bone will then be fixed with metal pins or screws and a metal plate. The incision will then be closed with stitches. Patients will be required to wear a cast, splint, or stiff soled boot for protection. In conjunction, crutches will also be provided to avoid applying pressure to the foot. Pain medications will be prescribed to help mitigate the pain. Patients are advised to keep the stitches and incisions clean and dry to prevent infection. Also, resting and elevating the foot for at least a week is advised, however the longer you can rest and elevate the foot, the better. Patients are asked to schedule an appointment two weeks after the surgery to assess the incision and remove the boot or splint. If the wound has healed properly, the stitches will be removed at this time. An X-ray will also be captured to check if the bones are aligning properly. After three to four weeks, if the incision site is healing correctly, patients can begin to apply some weight to the foot. Typically, after eight to twelve weeks the area is healed completely and physical activity can be resumed. 

Benefits and Risk Factors

Medical professionals do the best they can to provide alternative treatment options before surgery is recommended. However, like most surgeries, a metatarsal fracture repair comes with great benefits and some serious drawbacks. Some examples of the benefits of undergoing a metatarsal fracture repair include, proper realignment of the bones, prevention of future complications, decreased time spent healing the injury, and restored foot functionality to pre-injury levels. With proper aftercare, most risks and complications associated with this surgery can be avoided. The most common risks include infection at the incision or in the bone, failure to heal, fracture in nearby bones due to stress, development of new callouses, and swelling of the foot. As mentioned, the metatarsal bones are the long bones in the foot that connect the ankle to the toes. These bones are incredibly significant to maintaining balance as an individual walks or stands. Each person heals differently and in their own time, so it is important to take care of your foot as you heal. If you or someone you know is battling a metatarsal injury it is highly advised to speak with a podiatrist about next steps.

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