Fracture of the fifth metatarsal bone of the foot: how long does it take to heal, rehabilitation

Metatarsal bones are part of the group of small tubular bones of the human skeleton. Metatarsal fractures are the most common bone fractures in the foot. Namely, fractures of the base of the fifth metatarsal bone that occur as a result of inversion of the foot. The location of the fracture should be carefully analyzed by a doctor, since the treatment of fractures of different location and nature varies quite a lot.

Types of fractures of the metatarsal bones of the foot

There are two main types of metatarsal fractures:

• Traumatic fractures - due to acute (sudden) injury to the middle and forefoot.
• Stress fractures are due to excessive long-term stress or repeated minor trauma against a background of completely normal metatarsals.

Fractures of the metatarsal bone of the foot are also classified according to location, nature of the fracture and the presence of displacement:

• Fractures of the base, body or subcapitate fractures of the metatarsal bones;
• Fractures of the metatarsal bone with or without displacement;
• Fractures are oblique, transverse, helical, comminuted.

Prevalence

Metatarsal fractures account for 5% to 6% of all skeletal fractures. They are equally common among men and women of the planet.

To understand the mechanism of metatarsal fractures, it is probably best to start with a brief explanation of the anatomy of the foot.

The human foot consists of 26 bones:

• 5 metatarsal bones. These are tubular bones that are located between the tarsal bones and the phalanges of the fingers. Functionally, the metatarsal bones play an important role in movement, acting as a lever during foot movements (steps, running, jumping).
• 14 phalanges of fingers. The first finger consists of two phalanges, the remaining fingers - of three.
• 3 sphenoid bones. Located between the navicular bone and the first three metatarsal bones.
• Cuboid
• Scaphoid
• Talus
• Calcaneus

Together, the bones of the foot form a very complex mechanism that compensates for the enormous loads throughout the day and helps absorb the shock of every step.

Team of Doctors

1. Stand barefoot on the floor, rise on your toes, try to hold on for 10 seconds (if you don’t succeed, then as long as you can).

The number of repetitions of each exercise increases to 7-8, the complex itself should be repeated 5-6 times a day.

Postoperative physical therapy for hallux valgus helps speed up recovery and reduce swelling. In this regard, lymphatic drainage massage is very useful, which can be started 2 weeks after the intervention. Magnetic therapy, pressotherapy, electrophoresis with agents that normalize vascular tone improve microcirculation and lymph flow.

Symptoms of fractures

• Pain that develops gradually and increases with exercise
• Foot swelling
• Subcutaneous hemorrhage (bruise)

Patients with these symptoms typically experience a sudden onset of sharp, intense pain following an injury. Sometimes the patient may hear a crunching or clicking sound at the time of injury. The pain causes the patient to limp. Patients with a metatarsal fracture are also accompanied by swelling, which increases during the day and decreases at night. In severe displaced metatarsal fractures, obvious deformity may not be noticeable.

In 10-14 days

During this period, the sutures are removed, or, if the doctor used absorbable suture material, they disappear on their own. From this moment, you can begin to prevent pathological scarring. To ensure that the seam after surgery is thin, even and invisible, you can use silicone-based patches and gels: Kelo-Kot, Dermatix.

Since prolonged immobility contributes to venous thrombosis and thromboembolism, during this period the doctor may prescribe drugs that reduce blood clotting, such as Aspirin Cardio or Thrombo-Ass. It is better to wear compression stockings on your feet (there are models without socks and toes).

Diagnosis of metatarsal fractures

For a more detailed understanding of the problem, the doctor finds out from the patient the mechanism of injury, including the force, location and direction of the blow.

Stress fractures are usually associated with increased intensity or duration of repetitive movements such as running, ballroom dancing, and others.

Examination: Careful examination and examination of the entire foot and ankle is critical in identifying associated injuries. Deformity, swelling and hemorrhage are easily visualized.

X-rays in 2 projections are usually sufficient to diagnose a fracture. But with stress fractures without displacement, sometimes it is impossible to determine them even for a very experienced doctor.

In such cases, control radiographs are prescribed after 10-14 days, when bone tissue resorption occurs at the fracture site. Stress fractures are also difficult to see on x-rays until they begin to heal and callus begins to form. This is exactly what is clearly visible on x-rays. A CT scan or MRI may be necessary to rule out stress fractures and other foot pathologies.

First aid for metatarsal fractures

• Limiting loads and movements. It is important to limit movement and stress on the foot to prevent further damage.
• Cold locally. Using ice will help slow or reduce swelling and provide a numbing sensation that will relieve pain. It makes sense to apply ice to the injury site for the first 48 hours after the injury. Never hold ice for more than 20 minutes at a time to prevent frostbite. A break of 1.5 hours before repeated exposure to ice, this allows the tissues to return to normal temperature and trophism, repeat as necessary. You can wrap any frozen product in a towel and apply it to the damaged area. Ice should be applied as soon as possible after the injury. (Do not place ice directly on your skin. Also, do not leave ice on while you sleep, or leave it on for more than 30 minutes. This may cause frostbite.)
• Elastic bandaging. You need to bandage your leg with an elastic bandage. But bandage it correctly, not too tightly. If your fingers become cold or numb, it means the bandage is too tight. An elastic bandage will limit swelling and limit movement in the joint. You can sleep without a bandage. But be sure to move around with your leg wrapped in an elastic bandage.
• Elevated position. Elevate the injured leg, such as resting your leg on a pillow while lying on a sofa or bed. If you are sitting, you can rest your leg on a chair to reduce swelling and pain.

Avoid: heating the damaged area during the first week, rubbing with alcohol and massage, which can aggravate the swelling. For example, exclude hot baths and saunas. Heat has the opposite effect compared to ice. That is, it stimulates blood flow.

It is important to limit the load when walking (do not rely entirely on the foot) until the injury has been diagnosed by a doctor.

When you need to see a doctor and have your wound examined

1. The bandage was wet with wound discharge. This shouldn’t happen, and we need to figure out what happened.
2. The patient developed a fever, malaise, and chills. These may be signs of an infectious complication, and a doctor's examination is necessary as soon as possible.
3. Over time, the patient's condition does not improve. Soreness and malaise immediately after surgery to remove hallux valgus (as after any intervention) is normal. But every next day should be easier than the previous one. If relief does not occur, you need to look for the cause.

Treatment of fractures of the metatarsal bones of the foot

Conservative treatment of moldy bone

Treatment tactics will depend on the location of the fracture and its severity.

The goal of any treatment for metatarsal fractures is to help the patient return to a full life. Following your doctor's recommendations will help you quickly restore foot function and prevent further problems in the future.

We are convinced that for non-displaced fractures, adult patients do not need to apply plaster, as this causes a lot of inconvenience, and they are able to understand that it is necessary to limit the load in order for the fracture to heal as quickly as possible. Displacement of bone fragments does not occur without load. But it is difficult to explain to our young patients that they should not step on their feet or walk only with support on their heels. That's why we cast children.

As a rule, in case of traumatic fractures, it is recommended to walk only with support on the heel or without any support at all, moving with crutches.

In case of stress fractures, it is recommended to walk with partial weight bearing on the foot, but always in individual orthopedic insoles, which “unload” the damaged area.

If the metatarsal fracture is slightly displaced, an attempt is made to reduce it and fix it with a plaster splint.

If the fracture is accompanied by a significant displacement of bone fragments (more than half the width of the metatarsal bone), the issue of surgery is decided.

Gymnastics for the joint

From this moment it is time to begin to develop the operated joint. There is a set of special exercises. At first, gymnastics can be extremely unpleasant, but it is necessary. By the time the pain goes away, the joint will become immobile, and no set of exercises will be able to help. It is best to do exercises when treating foot deformities under the supervision of a rehabilitation physician and with his help (at least at first).

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Surgery for a metatarsal fracture

The indication for surgery for a fracture is displacement of metatarsal bone fragments by more than half the width of the bone.

Percutaneous pin fixation

It has been popular for many years and continues to be one of the most popular methods internationally.

First, the doctor closes the displacement of the fragments, then wires are drilled through the fragments in certain (taking into account the nature of the fracture) directions.

Pros: low trauma, speed, ease, low cost, absence of an incision and, as a consequence, a postoperative scar.

Disadvantages: the ends of the wires remain above the skin so that the wire can be removed after the fracture has healed; the risk of wound infection and penetration of infection into the fracture area; long-term wearing of a plaster cast for 1 month; inconveniences in everyday life.

Open fracture reduction

Open reduction for a fracture of the metatarsal bone of the foot, external osteosynthesis with a plate and screws. The operation involves a surgical incision, access to the broken metatarsal bone by carefully retracting the tendons, vessels and nerves, mobilization of bone fragments, elimination of displacement and fixation in the correct position.

Plaster immobilization is not carried out, since the metal structure fixes the fragments.

Walking with support on the heel area is allowed for a month.

Myths about surgery to remove hallux valgus

There are many myths among people regarding surgical removal of a bunion. Let's dispel some of them.

You cannot have surgery if you have arthritis or arthrosis. In fact, these diseases are considered relative contraindications. The operation is possible, the doctor will just treat you with more attention.

It is useless to operate: the bone will soon grow anyway. With a high-quality intervention, the probability of re-development of hallux valgus deformity tends to zero. Relapses occur, but are extremely rare.

You will have to sit for a long time without moving and wear a cast. Modern technologies make it possible to move independently within a few hours after the procedure. The bones are held together by special structures, so there is no need for plaster.

Rehabilitation after a metatarsal fracture

As soon as the fracture of the metatarsal bone heals and the pain decreases, the doctor will allow you to step on the foot in doses and gradually increase the load.

Don't self-medicate!

Only a doctor can determine the diagnosis and prescribe the correct treatment. If you have any questions, you can call or ask a question by email.

Recovery period

You can get up the next day after surgery to correct hallux valgus, but it is better to do this only to go to the toilet, walking in special orthopedic shoes. It is best to stay in bed as much as possible. The operated leg should be in an elevated position, above the level of the heart. This will help drain blood and lymph from the operated leg and reduce swelling.

Before removing the stitches, the bandage must not be exposed to water under any circumstances. Therefore, during hygienic procedures, the leg should be wrapped in polyethylene, and it is better to limit yourself to local ablutions at this time.

There are two fundamentally different medical approaches to control during this period. Some doctors believe that it is better to play it safe and invite patients for dressings, during which they look at the condition of the wound. Others believe that there is absolutely no need to force a person after surgery to get to the clinic to remove the bandage, look and apply a new one: most often, recovery after valgus surgery does not require intervention.

Cost of surgery to remove hallux valgus

The doctor calculates the exact cost of the operation. It is very difficult to name a specific figure - it varies from twenty to eighty thousand rubles. This depends on the type of surgical intervention chosen by the attending physician (in accordance with the stage of the disease and physiological characteristics of the patient), the type of anesthesia, outpatient or inpatient stay, materials and instruments used. To keep the price low, come get rid of hallux valgus in a timely manner, on an outpatient basis, using minimally invasive intervention.