There are 5 metatarsals in each foot. They are long bones present in the forefoot. They form metatarsophalangeal (MTP) joints with the phalanges or the toe bones at the origin of each toe. Fracture of the metatarsals is the most frequently occurring traumatic foot injuries. People who play professional sports such as football (soccer) commonly suffer from this fracture.
Causes of Metatarsal Fracture
Metatarsal fractures can occur in two ways, acute fracture or fracture due to stress on the foot. Acute fractures take place as a result of direct trauma or impact to foot such as seen in a violent game of football, whereas stress fractures occur gradually due to repetitive impact or stress to the bone. Violent impact to the foot such as dropping something heavy on the foot results in a metatarsal fracture. Any sudden, violent twisting or turning of the ankle also results in a fracture, especially the 5th metatarsal. There may be an avulsion fracture, where a piece of bone is detached along with the tendon of the Peroneus Brevis muscle or a Jones fracture which occurs at the base of the 5th metatarsal as this region usually has poor blood supply and it also makes the healing difficult.
Symptoms of Metatarsal Fracture
- Severe pain in the foot.
- Instant swelling.
- Inability to bear weight.
- The foot may appear crooked or deformed.
- Bruising appears within 24 hours.
Treatment of Metatarsal Fracture
- Patient should seek medical consultation from a sports injury specialist immediately.
- X-rays of the foot will confirm the fracture.
- A short cast or boot can be placed if there is no displacement of the bones for at least three weeks.
- Ice pack application helps in reducing pain and swelling.
- Patient should avoid weight bearing.
- NSAIDs or other pain killers are useful for pain relief.
- X-ray of the foot should be taken again after 6 weeks to make sure there is complete healing of the bones.
- Surgery may need to be required in case of complex or displaced fractures. It comprises of fixing the bones with screws and pins.
- For Jones fracture, the foot should be immobilized for 6-8 weeks.
- After the cast has been removed, patient should enroll in a rehabilitation program to restore mobility and strength of the foot.
- Athletes should return back to training and sports gradually.
- Proper footwear which provides protection should be worn to prevent metatarsal fractures.