A painful injury common to football players and dancers is a fracture of the fifth metatarsal. Anyone else can get injured when walking on an uneven road, jumping unsuccessfully or hitting a curb with their foot.
If you encounter such a problem, contact your doctor. This is a guarantee of conducting a detailed diagnostic examination, correct diagnosis taking into account individual characteristics and prescribing effective treatment.
A speedy recovery will be facilitated by highly qualified traumatologists and orthopedists, experienced radiologists, the use of modern Dutch equipment, as well as a pleasant, comfortable atmosphere in the clinic.
Description of injury
The metatarsus is called the midfoot. These are five tubular bones connecting the tarsus and phalanges of the fingers. The metatarsus is involved in the formation of the arches of the foot and is responsible for the shock-absorbing function, ensuring the correct biomechanics of the foot during jumping, running, and fast walking.
Violation of the integrity of one or more bones leads to difficulty in supporting the injured leg and moving independently. And in the absence of proper treatment, the patient may subsequently develop post-traumatic flatfoot.
In traumatology, there is a classification of fractures of the metatarsal bone of the foot. If the fracture occurred as a result of injury, the fracture is considered traumatic. If the provocateur is regular intense stress and bruises, it is called fatigue.
Depending on the location of the damage, the following types are distinguished:
- Jones fracture - affects the fifth bone, the damage to which requires long-term treatment.
- Avulsion - appears when the foot is subluxated, accompanied by sprained ligaments and an ankle fracture.
- Subcapital – when the necks of the bones are broken.
Sometimes the middle part or directly the heads of the metatarsal bones are damaged. If the integrity of the skin is broken and an exposed bone fragment is visible through the open wound, this is an open fracture. A closed injury is one that is localized in the thickness of the soft tissue without damaging the surface layers.
According to the relationship of bone fragments, there is a fracture without displacement and with displacement. A single metatarsal fracture is rarely displaced. When one bone is damaged, nearby formations begin to act as a splint, holding the fragments in the correct position.
Foot structure
The human foot is a rather complex multifunctional structure. It is based on 26 bones interconnected by movable joints and reinforced by multiple muscles, flexible ligaments, strong tendons and cartilage. Doctors conventionally divide the foot skeleton into three main sections:
- tarsus;
- metatarsus;
- fingers.
The first part of the foot skeleton contains seven bones: the calcaneus, talus, navicular, cuboid and three sphenoid bones. The second part is the metatarsal bones. There are only five of them. They have a tubular structure and vary in length and thickness. The skeleton of the finger consists of the main, middle and nail phalanges.
Fractures of the tarsal bones most often occur from a sharp landing of a heavy or massive object on the inside of the foot, as well as from excessive flexion, rotation, or excessive axial load. Based on its anatomical structure, a fracture of the fifth metatarsal bone is the leader among all possible injuries of the lower extremities. This bone is quite fragile, and is also located in the front, most injured part of the foot. Most often it is broken when the foot is twisted sharply. Fractures of the 2nd, 3rd and 4th bones occur less frequently.
Symptoms
A fracture of the metatarsal bone of the foot is accompanied by a clinical picture, the severity and characteristics of which depend on the type of fracture. When one metatarsal bone is damaged:
- pain intensifies when trying to lean on the foot or when palpating the damaged area;
- the foot swells locally over the broken bone on the dorsal and plantar side;
- subcutaneous hemorrhages may not appear immediately, but after a few hours, as a rule, they are not extensive;
- When palpated, crepitation (crunching) is heard.
The foot is deformed, the toes may be visually shortened.
If the fracture is multiple, the following appears:
- severe swelling covering the entire surface of the foot;
- pronounced extensive subcutaneous hematomas;
- the foot hurts a lot, it hurts to touch it;
- it is impossible to lean on the injured leg;
- the foot is deformed.
If the fracture is open, the injury is complicated by bleeding and traumatic shock. The condition is characterized by pale skin, increased or slow heart rate, and a sharp decrease in blood pressure. Some victims may develop fainting.
Jones Fracture Symptoms and Diagnosis
A Jones fracture is accompanied by the following symptoms:
- swelling over the damaged area;
- hematoma (not necessary, but if it appears, it spreads to the ankle joint);
- When putting weight on the injured foot, acute pain occurs. At the same time, at rest it becomes less noticeable and acquires a dull or aching character;
- Sometimes there is numbness of the skin and tingling in the area of injury.
If the fracture is of the fatigue type, then pain occurs some time after the start of movement. Its intensity may be weak. It is for this reason that people with such an injury continue to lead an active lifestyle, which later leads to complications.
To make a diagnosis, an x-ray and/or MRI is required.
Causes
A fracture of the metatarsal bone of the foot can occur for traumatic and pathological reasons.
Mechanical damage is caused by:
- a strong direct blow to the foot from above;
- dropping a heavy object onto your foot:
- compression of the foot from above and below;
- load at the moment of rotational movement.
Often such fractures appear after road accidents. Running over a leg with a vehicle causes a crack in the bone or a complete fracture.
Pathological causes include:
- decreased bone density due to osteoporosis;
- leaching of calcium salts from a person taking diuretics for a long time;
- excess load in obesity.
Fractures are more common among older people and professional athletes. Constant intense loads, which are accompanied by regular minor injuries - subluxation, bruise, are a predisposing factor in the subsequent violation of bone integrity.
A similar picture is observed among army recruits due to the increased load on the foot.
Treatment
Therapeutic measures begin even before qualified assistance is provided. It is important to take the correct pre-medical actions at the scene of the incident:
- Provide rest to the victim and do not allow him to stand up or move the injured leg.
- If possible, remove your shoes; if this requires effort, then there is no need to do so.
- Apply cold to the fracture site: frozen foods wrapped in cloth, a hypothermic “Snowball” bag. The duration of exposure should not exceed 15 minutes to avoid local hypothermia.
- Immobilize the foot by applying a splint, or fix it between two flat planks.
- In case of severe pain, you can take a painkiller - Baralgin, Ketanov.
The victim should be taken to a doctor immediately. Any delay may result in the development of unwanted complications.
A traumatologist treats a fracture of the metatarsal bone of the foot. Before prescribing therapeutic procedures, a diagnosis is carried out. In addition to a visual examination and listening to the patient’s complaints, the doctor records the time and details of the injury, and prescribes an x-ray examination. The picture is taken in 2-3 projections, depending on the type of fracture. After confirmation of the diagnosis, treatment tactics are drawn up.
Types of therapy:
- For a simple fracture without displacement, a plaster splint is applied for 1 month. The duration of fusion may increase if the patient has a calcium deficiency in the body. To speed up regeneration, calcium preparations are prescribed - Kalcemin, Calcium D3 Nycomed. The plaster cast is removed only after a control x-ray, which confirms the formation of callus.
- When the ends of the damaged bone are displaced, closed or open reposition (comparison) of the fragments is performed. If the operation is performed using the open method, it is necessary to fasten the bone parts with special staples and pins. In some cases, skeletal traction is indicated. In this case, the cast will have to be worn for about 12 weeks.
During the treatment period, the patient is required to exclude any load on the injured foot. You should only move around with the help of crutches. After removing the cast, it is recommended to wear a medium-fixation bandage, which is eventually replaced with an elastic orthosis. It is necessary to insert orthopedic insoles into shoes to avoid the development of flat feet.
Medicines prescribed:
- NSAIDs for relieving pain and preventing an inflammatory reaction - Ketoprofen, Ketorol, Diclofenac;
- chondroprotectors to speed up bone tissue metabolism - Teraflex, Artra;
- calcium preparations for healing fractures of the metatarsal bones of the foot - Kalcemin Advance.
- diuretics to remove excess fluid - Furosemide, Diuver.
Exercise sets
To speed up the recovery process, you need to devote time to exercise therapy every day.
The complex includes exercises that are performed 10-20 times:
- Rotate the foot in a circle (clockwise and counterclockwise).
- Turns to the sides, down and up the feet.
- Compression, extension of toes.
- They place the ball under the foot, begin to roll it, roll it from toe to heel and vice versa.
- They sit on a chair, rise, transfer their body weight to their heels, smoothly rolling onto their toes. Over time, this exercise is performed leaning on a chair, and later – standing.
- They lie down on a flat surface and swing their legs (crosswise).
Additionally, you can do the following interesting activities:
Rehabilitation
The speed of recovery after a fracture of the metatarsal bone of the foot depends on various factors:
- severity of injury;
- age of the patient;
- accompanying pathologies.
For example, in patients with diabetes, as well as in older people, tissue regeneration slows down significantly. A history of osteoporosis requires special attention and intensive therapy.
The rehabilitation period includes a set of procedures, the goals of which are to completely restore the functionality of the foot and return the patient to a working condition. For this purpose they prescribe:
- physiotherapy;
- massage;
- a set of therapeutic exercises.
A metatarsal foot fracture will heal faster if the patient undergoes a full course of physical therapy. The recovery method is prescribed by a doctor and is available at home. It could be:
- magnetic therapy;
- electrophoresis;
- Ural Federal District;
- phonophoresis;
- laser therapy.
Mud baths and paraffin applications are useful. Each of these methods increases blood circulation, improves nutrition and regeneration of damaged tissues.
The massage course is aimed at restoring mobility and strengthening the ligamentous apparatus. Sessions should be conducted by a qualified specialist who has the technique of therapeutic massage.
Therapeutic exercises are prescribed after removing the plaster cast. The list of exercises and their frequency are prescribed by the doctor together with the physiotherapist. The first classes are conducted under the guidance of an instructor who teaches the correct technique and teaches how to dose the load. In the future, it is recommended to regularly perform therapeutic exercises at home.
A set of basic exercises:
- Flexion and extension of the toes on the injured leg.
- Sitting on a chair, perform heel-to-toe rolls.
- Bend your foot, stretching the front part of it forward and back, in the opposite direction. In this case, a noticeable tension should be felt.
- Rotate the foot to the left and right.
- Rolling a massage roller, a small ball or a bottle filled with water on the floor.
- Rotate the foot in a circle in different directions.
- Exercise "scissors" in a lying position - crossing slightly raised legs.
Each movement should be performed slowly and smoothly. In this case, the patient should not experience pain. If pain occurs, exercise should be stopped and your doctor informed.
If you follow all the specialist’s recommendations, it will take from 1.5 to 3 months to restore your ability to work. In most cases, the prognosis is favorable. Impaired functionality may be a consequence of delay in contacting a doctor and attempts at self-medication.
Ankle out
Sitting on the floor, the leg being worked out is extended and further from the door, the healthy leg is bent at the knee. Wrap one end of an elastic band or expander around the toe of your sore leg, and secure the other end to a door or any stationary object at the level of your ankle. Gently tip the toe outward, stretching the elastic. Return to the starting position. 2 sets of 15 reps.
Prevention
A fracture of the metatarsal bone of the foot can be prevented by following simple rules:
- eat right and lead an active lifestyle;
- monitor your weight and prevent the appearance of extra pounds;
- wear comfortable shoes with heels no higher than 4 cm;
- perform feasible physical exercises to strengthen ligaments and muscles;
- go swimming.
If you suspect a fracture, do not try to cure the injury yourself, but immediately contact a medical facility.
Consequences and possible complications of a Jones fracture
Since the bone has limited blood flow, 15-20% of fractures do not heal. This is the main complication of a Jones fracture. Other typical complications:
- thrombus formation after surgery;
- the need for reoperation due to nonunion, wound infection, or formation of a pseudarthrosis;
- muscle tissue atrophy;
- chronic pain.
The likelihood of developing complications after a Jones fracture is minimized by careful adherence to therapeutic instructions.