Injuries to the Metatarsal Bones
Foot structure is complicated. Our feet are made up of bones, muscles, tendons, and other soft tissues. Nineteen of the twenty-six bones in our feet are toe bones and metatarsal bones. Toe and metatarsal bones fractures are common injuries. There is a common misconception that a doctor can't do anything for toe or foot fractures, but that is not true. It's actually important to see a doctor and have the foot or toe evaluated and treated appropriately. Even if treatment has already been received in an emergency room, a proper evaluation and diagnosis by a podiatrist is important.
What Is a Fracture?
A fracture is just a break in the bone. It is no different from a broken bone. Fractures can be divided into two categories: traumatic fractures and stress fractures.
Traumatic fractures are also called acute fractures and are sustained when the foot or toe suffers a direct blow or impact. This can be from something falling on your foot, or from just badly stubbing your toe. There are two types of traumatic fractures: displaced and nondisplaced. When the fracture is displaced, the bone is broken in a way that has made it change position or dislocate. Traumatic fracture treatment will depend on where the fracture is located, the extent of the break and whether the fracture is displaced or not. Surgery may be necessary to treat some traumatic fractures.
Signs and symptoms of a traumatic fracture include:
- An actual sound when the break occurs.
- “Pinpoint pain," which is pain at the place of impact. This pain will arise at the time the fracture occurs and perhaps even be around a few hours later, but the pain usually fades after several hours.
- Deviation of the toe.You may notice your toe has an odd or abnormal appearance.
- Bruising and swelling on the day following the traumatic event.
- It isn't true that “if you can walk on it, it's not broken.” An evaluation by a podiatrist is always recommended for any type of fracture.
Stress fractures are small, hairline breaks typically caused by some sort of repetitive stress. Stress fractures are common among athletes. Especially athletes who aren't careful to regulate their exercise and push themselves too hard. Suddenly increasing your workout routine or running mileage can cause stress fractures to occur. Stress fractures can also occur due to an abnormal foot structure, a deformity, or osteoporosis. Wearing inappropriate footwear can also contribute to the development of stress fractures. If you believe you are suffering from a stress fracture, do not ignore the pain. Stress fractures will just reoccur if they are not treated properly.
Stress fracture symptoms include:
- Pain during or following normal activity
- Pain which fades away when at rest and reoccurs when standing or when pursuing an activity
- Pain at the site of the fracture when it is touched. This is called "Pinpoint Pain".
- Swelling, but no bruising
Sprains have similar symptoms, but sometimes with a sprain, the whole area hurts instead of just one point. Your podiatrist at Neuhaus Foot and Ankle will diagnose your condition, whether it is a sprain or a fracture, and recommend the best treatment option for you. Some sprains or dislocations can be disabling. Without proper treatment for sprains and fractures, you can develop debilitating arthritis.
Consequences of Improper Treatment
It is a common and dangerous misconception that a doctor can't do anything to treat a broken bone in the foot. Actually, if a fractured toe or metatarsal bone is left untreated, serious complications can occur. For example:
- A deformity can develop in the bony architecture of the foot, which can limit the mobility of the foot or make getting a proper shoe fit difficult or even impossible.
- Arthritis may develop
- You may suffer chronic pain and long-term dysfunction in the foot or toe
- Non-union, or failure for the bone to heal properly, can lead to subsequent surgery or even chronic pain.
Treatment of Toe Fractures
Toe fractures are almost always traumatic fractures. Treatment for a traumatic fracture will depend on the specific break and your situation, but it may include some of the following options:
- In some cases, rest will be all that is necessary to treat a toe fracture.
- A splint may be utilized to keep the toe in a fixed position.
- Your doctor may recommend wearing a rigid or a stiff-soled shoe to protect the toe and help keep it in position.
- Sometimes it is okay to "buddy tape" your toe the adjacent toe, but this can be harmful in some situations.
- Surgery may be needed in some cases. Surgery usually involves the use of fixation devices, such as pins or screws.
Treatment of Metatarsal Fractures
Metatarsal fractures can be either stress or traumatic fractures. Some types of fractures in the metatarsal bones present unique challenges. For example, in some cases a first metatarsal bone fracture can lead to arthritis. Arthritis in the toe can be especially painful because we bear a lot of weight on our toes when walk and bend our foot. Another kind of break, a Jones fracture, occurs at the base of the fifth metatarsal bone. Jones fractures are often misdiagnosed as ankle sprains, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. That's why you should see a podiatrist. A podiatrist is an expert in correctly identifying these conditions as well as other problems of the foot. Treatment of metatarsal fractures depends on the type and extent of the fracture, but may include:
- Rest. Rest may be the only treatment necessary in healing some fractures.
- Stress fractures develop due to repetitive stress, so it is important to avoid the activity that led to the fracture in the first place. You may also need to be on crutches or in a wheelchair to take some pressure off the foot and give it time to heal.
- You may be advised to wear a stiff-soled shoe or another form of immobilization to protect the fractured bone while it is healing.
- Some traumatic fractures of the metatarsal bones may require surgery to heal properly, especially if the break is badly displaced.
- Your podiatrist will provide instructions for care following surgical or non-surgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return to normal activities. No matter what treatment is instructed for you, follow-up care is important for correct healing of fractures.