The main questions for patients when contacting a traumatologist with a fracture of the metatarsal bones: “How long will I have to wear a cast? Is it necessary to walk with crutches after a fracture? How to get back on your feet after an injury? This article will answer these and many other questions of interest.
The human foot is an anatomically complex structure and consists of bones, muscles, ligaments and tendons, including soft tissues. In total, the human foot consists of 26 bones, of which only five are called metatarsals. They are the longest in the foot. What threatens a fracture of the 5th metatarsal bone? More on that later.
Relevance of the problem
According to statistics today, if we talk about fractures of the metatarsal bones, this is five to six percent of the total number of all fractures of the bones of the human skeleton. These injuries are not uncommon in both males and females. The most common fracture is the 5th metatarsal bone, as well as the 4th (this is affected by their location inanatomically, the third metatarsal bone is broken very rarely).
The bones that make up the human foot create a rather complex mechanism that performs many functions, namely: they carry out the movement of a person, withstand heavy loads of a different nature. They provide shock absorption during human walking.
All the bones of the foot in humans, and their number is 26 pieces, are very closely related to each other. If one of them is injured, damaged or displaced, then this can affect further deformities and dysfunctions of the others.
Groups at risk of fracture:
- People between the ages of twenty and forty.
- Men actively involved in sports.
- Ballerinas.
- Footballers.
Open or closed fracture of the 5th metatarsal is common in these categories.
Anatomical structure of the human foot
- The metatarsal bones are 5 tubular bones located between the phalanges of the fingers and the tarsal bones. Their main function is to provide active movement of the foot and play the role of a lever (running, walking and jumping).
- Short tubular bones (phalanges) of the toes. The 1st toe consists of 2 phalanges, all the rest of the 3. The total number of them on each leg is 14. A fracture of the 5th metatarsal bone can occur completely by accident.
- Three cuneiform bones. They are so named because of their wedge shape.
- The cuboid bone is located at the lateralparts of the foot.
- The scaphoid lies at the forefoot.
- Talus.
- Heel bone.
If a person has a fracture of the 5th metatarsal bone, then he should contact an orthopedic traumatologist.
Types of fractures
Fracture of the metatarsal bones is understood as a violation of their integrity due to injury.
They are classified as:
- Due to injury.
- Due to fatigue or stress.
Various fracture lines:
- Transverse.
- Slanting.
- T-shaped.
- Wedge-shaped.
Fractures due to trauma
Let's consider fractures caused by trauma. They can form due to a blow to the foot with a heavy object, as well as tucking of the foot in the process of walking or running.
The following types of fractures are classified:
- Fracture of the 5th metatarsal bone with displacement - as a result of a fracture, bone fragments are displaced.
- Bone fragments do not move.
- Open fractures.
- Closed fracture of the 5th metatarsal.
If a person has received such an injury without displacement, then the elements of the damaged bone will remain in the same position. An open fracture is accompanied by a violation of the integrity of the skin, in which case parts of the bones can be seen in the wound.
An open fracture is dangerous for a person, since the percentage of infection and the occurrence of complications in the future, such as phlegmon, osteomyelitis, sepsis,gangrene and tetanus, very high. How long does it take for a 5th metatarsal fracture to heal? More on that below.
Main clinical signs
- Pain at the site of a fracture of these bones appear either immediately after the injury or after some time.
- Bone damage at the moment of injury is accompanied by a crunch that the patient can hear.
- Possible metatarsal deviation to the side.
- The patient has a visually shortened toe.
- Possible swelling the day after the fracture or the same day.
Jones fracture
One of the varieties of such injuries is the Jones fracture. This is a fracture of the 5th metatarsal bone with a displacement, in which the fragments slowly grow together. After it, in some patients, the bone never grows together.
Often, patients can be misdiagnosed. As a result, a foot sprain treatment is prescribed.
Fatigue fractures
These are injuries that are characterized by cracks that are barely noticeable on x-rays.
Reasons for this phenomenon:
- Heavy exercise on the foot area.
- In particular, observed among athletes who, in the process of running, quickly increase their mileage in marathons.
- Structure and shape of metatarsal bones with deviation.
- Changing the shape of the foot.
- Impact of tight shoes when worn.
- Often diagnosed in professional ballroom dancerslevel.
- Osteoporosis.
The above types of fractures require mandatory and timely treatment. Negligent attitude to such an injury can seriously affect the condition of the foot in the future.
How to diagnose such a fracture?
- The patient has pain in the foot after exercise (long walking or running).
- Pain goes away after a short rest and then gets worse again if the person starts walking around the room or stands in one place for a long time.
- When probing the foot, the patient indicates a point pain at the fracture site.
- The outward sign of a fracture is swelling of the foot, but no bruising.
The above symptoms suggest that you need to see a traumatologist. Similar signs are observed with a fracture of the metatarsal bones and sprains. The belief is considered erroneous: if the patient walks, then he does not need medical care. Diagnosis of a fracture of the base of the 5th metatarsal bone of the foot, carried out untimely, and unqualified treatment of any fractures, including fatigue ones, leads to serious consequences.
What are the complications?
- The bone structure of the human foot changes, leading to limited movement and making it difficult to wear shoes.
- Possible development of arthrosis at the site of injury.
- The alignment of the displaced bone elements is important, otherwise angular deformation may occur.
- Patientsuffering from chronic foot pain.
- The patient quickly feels tired in the legs, and especially when he walks or stands still.
- If the fracture does not heal, then surgery is necessary.
Diagnosis
After a fracture of the base of the 5th metatarsal bone, the diagnosis can be made by the presence of trauma, patient complaints, visual examination of the foot, as well as using X-ray equipment.
Treatment
Modern types of treatment in traumatology:
- Imposition of a plaster cast. It is used in the case when there was a fracture of the 5th metatarsal bone of the foot without displacement of the fragments.
- A cast is used to protect the site of injury from various types of impact on the fracture, ensures the correct position of bone fragments in the anatomical plan and the immobility of the foot, which is necessary for rapid healing.
- Surgical operation. The displacement of bone fragments as a result of a metatarsal fracture requires surgical intervention, as well as the use of mini-implants for their fixation and comparison.
- The patient needs to use crutches while walking for the entire period, regardless of the type of treatment (surgical or conservative). Crutches help relieve stress on the foot.
- When the patient is allowed to remove the bandage, a rehabilitation course awaits him to return to active life and restore foot function.
Modern medicine provides a new method of treatment, the so-called osteosynthesis,with which the doctor is able to compare bone fragments and give them the correct position. With the help of a special rod, fixation is carried out inside the bone. This technique makes it possible in the early stages to use the load on the foot and make more movements with the toes.
Need for immobilization
In order to minimize the acute consequences of a metatarsal injury, rest and a limited set of movements are needed, which, in turn, will help to eliminate secondary displacement and create all favorable conditions for rehabilitation.
If the victim has no displacement of the fragments, then the cast in case of a fracture of the 5th metatarsal bone is changed to a special orthosis.
It allows you to do physical activity on the leg, without provoking pain and swelling of the soft tissues of the foot.
Together with the immobilization of the fracture, painkillers, physiotherapy, vascular preparations and decongestant ointments can be prescribed. The decline in this phenomenon suggests that five to seven days after a fracture of the 5th metatarsal bone, it is possible to conduct a control radiography.
So, a sharp increase in physical activity on the foot leads to fractures of the fifth metatarsal bone. Patients complain of pain when they exercise regularly. At first, it makes itself felt only during exercise, then the symptoms appear more and more often, as a result, a clinical picture of a “fresh fracture” develops.
The doctor needs to do an examination. He needs to examine both ankles, the scaphoid, and the base of the 5th metatarsal. Examination is carried out using X-ray equipment. For any fracture, and especially the 5th metatarsal bone, an x-ray of the foot is performed in 3 projections: lateral, anteroposterior and oblique. In severe cases, other imaging modalities may be used: MRI or functional imaging.
First aid to the victim
Prehospital first aid includes:
- Creating the necessary rest for the foot.
- It is necessary to apply cold to the area of the fifth metatarsal. An ice pack helps a lot. It is used to reduce swelling of soft tissues and reduce pain in the foot. At home, an ordinary towel is suitable, in which ice is wrapped. There is a certain period of time for which cold can be applied. It is necessary to do this procedure for twenty minutes every hour.
- Elastic bandage is suitable for fixing the foot in order to later put a compression stocking on the leg. Its use requires uniform bandaging in order to exclude circulatory disorders of the lower limb.
- The injured foot should be placed on a raised platform. The patient places the foot just above the hip.
- Possible foot splint.
- Find the nearest emergency room for medical attention.
5 metatarsal fracture: rehabilitation
A cast for a fracture is worn for a month and a half.
The attending doctor (traumatologist) canallow the patient to step on the broken leg only if a fused metatarsal fracture is visible on the x-ray. The plaster splint should be removed only with the permission of the doctor. Doing this is premature and prohibited. Physical activity during the recovery period is important to dose. The first thing the patient should do is to step exclusively on the heel and eventually put the load on the entire foot. The doctor prescribes physical therapy, which contributes to the rapid restoration of function and helps to return the patient with a fracture to normal life. In the event of pain during physical education, it is necessary to suspend the prescribed course.
Swimming, massage and physiotherapy have a positive effect. Water exercises with minor loads effectively restore the normal functioning of the foot. If the swelling of the leg has increased, you can use Lyoton 1000 or Troxevasin ointments.
Special orthopedic shoes and insoles prescribed by a doctor make the rehabilitation process more comfortable. It is also recommended to do "home exercises".
Exercise
"Home exercise" for the foot is as follows:
- Flex and extend the toes.
- Sitting on a chair, you need to "get up" on your toes and heels.
- Pull the foot towards you (ten to fifteen times).
- Pull the foot away from you (ten to fifteen times).
- Turn the foot to the left (ten times).
- Turn the foot to the right (ten times).
Foot function usually returns to normal 1 month afterplaster removal. To strengthen the bone, the patient should eat foods high in calcium and vitamins daily.
Fracture can happen to anyone, especially if a person leads an active lifestyle. You need to be careful, try to avoid traumatic moments, wear comfortable shoes and try to eat foods with sufficient calcium in them.
