Can You Break the Top of Your Foot

A metatarsal fracture occurs when one of the long bones of the midfoot is cracked or broken. This may exist due to sudden injury (an acute fracture), or due to repeated stress (stress fracture).

Where are the metatarsal bones?

The metatarsal bones are some of the most usually broken (fractured) basic in the human foot. There are 5 metatarsal bones in each foot. They are the long slim bones which run the length of the foot to the base of operations of the toes. For more information on pes anatomy, meet the separate leaflet called Heel and Pes Pain (Plantar Fasciitis).

A metatarsal fracture is a break in one of the v long basic which form the middle part of your foot.

5th metatarsal fracture

The fifth metatarsal bone is the nearly mutual metatarsal bone to be fractured in sudden (acute) injury to the foot. It may be broken at various points along its length, depending on the machinery of injury. The other metatarsal bones can also be broken. The first, second and fifth metatarsals are the near unremarkably injured in sport. Several well-known footballers take had metatarsal fractures in recent years.

Are there different types of break?

Breaks (fractures) tin exist acute, or caused immediately by injury. They can too occur over a longer flow of time, when they are called stress fractures.

An acute metatarsal fracture may be open or airtight, and displaced or not displaced:

• Open or closed: an open fracture is one where the skin is broken over the fracture so that there is a route of possible infection from the exterior into the broken bones. This is a more serious type of fracture, with more damage to the soft tissues around it making treatment and healing more than complicated. Specialist cess is needed.
• Displaced or non displaced: a displaced fracture is one where, post-obit the break, the bones have slipped out of line. A displaced fracture needs specialist intendance, as the bones will demand to be properly lined up and stabilised. This may involve an anaesthetic and some kind of metal pinning or plating to the bones.

Acute metatarsal fracture is commonly acquired past a sudden forceful injury to the foot, such as dropping a heavy object on to the pes, a autumn, kicking against a hard object when tripping, or from a sporting injury.

A stress fracture is a hairline intermission in a bone, acquired by repetitive stress. This is cracking which goes but partway through the os. There may be a single split in the bone, or multiple small splits. The hairline break or breaks practise non get through the full thickness of the bone, and so stress fractures are not generally displaced. Even so, several modest stress fractures can develop around the same area, over time.

What causes metatarsal fractures?

Acute metatarsal fractures

• These can be caused by direct injury to the foot. This may happen, for example, through someone stepping on or kicking the pes, by dropping something on to the foot or by falling on to the human foot.
• Twisting of the foot or the talocrural joint can also crusade fractures of the base of the 5th metatarsal. In this injury, the twisting mechanism pulls on a strong ligament that attaches to the base of the 5th metatarsal which then pulls off a fragment of bone.
• The shaft of the metatarsal is commonly injured because of twisting of the foot on landing from a leap. This is a common problem in ballet dancers.

Stress fractures

• This type of metatarsal fracture more often than not occurs due to repeated stress to the bone, which is also termed overuse.
• Are typically seen in those who have marched or run for long distances, especially if conveying heavy packs (which is why they used to be called 'march fractures').
• Oft bear upon athletes and sportsmen, although they tin can touch on any runners, fifty-fifty those who only run a lilliputian. They are ordinarily seen in the military during grooming exercises.
• They are common in runners who:

• Suddenly increment their running mileage or intensity.
• Run in poor footwear that doesn't suit their feet:
• People's choices and needs for running shoes vary. However, before choosing something unusual such as barefoot shoes or cosmetic shoes, make certain y'all have advice. For instance, for barefoot running y'all need to be taught the correct technique. Break in new running shoes gradually - many injuries result from a sudden alter in running shoes.
• Have only changed their running shoes and not 'broken them in' carefully.
• Continue to exercise despite having foot pain.
• They are as well frequently seen in ballet dancers and gymnasts.
• Abnormalities of the construction of the pes, and abnormalities of the bones and joints, such as rheumatoid arthritis or 'thinning' of the bones (osteoporosis), tin brand stress fractures more than likely.
• They can as well occur in people who have lost nervus sensation in their anxiety due to neurological problems - for example, diabetes that has affected the feet.

Does osteoporosis cause metatarsal fractures?

Metatarsal fractures (of both types) occur more easily if the metatarsal bones are weakened due to 'thinning' of the bones (osteoporosis).

See the divide leaflet called Osteoporosis for more particular.

Does ageing make metatarsal fractures more likely?

Most metatarsal fractures occur in younger people, every bit they are more likely to be involved in the kinds of sports and marching activities that brand them more likely. However, as nosotros become older the 'springiness' and padding of our anxiety tend to reduce. This means that our feet absorb impact less well and it is easier to fracture basic. Supportive footwear will brand this much less likely.

See the divide leaflet called Ageing Feet for more than detail.

What are the symptoms of a metatarsal fracture?

Astute metatarsal fracture

• May make an audible sound at the time of the break and you volition usually take immediate pain and tenderness around the area of the fracture.
• The pain is often called 'pinpoint hurting' every bit it is quite well localised at the site of bear upon to the bone.
• Broken bones bleed, and then bruising and swelling tin can develop and yous may have difficulty putting weight on the affected foot.
• Motility of your pes may as well be limited. Surprisingly, all the same, pain tin settle within a few hours.

People sometimes say that information technology isn't possible to walk on a broken foot simply this is not correct. Whether you can walk on a cleaved pes depends on which bone is broken (and whereabouts forth its length), whether the fracture is displaced, how supportive your shoes are, and your personal tolerance to hurting. It is, therefore, possible to walk on a broken foot, although it is probable to be very uncomfortable to practise and so and it may well make matters worse if you do.

Stress fractures

• Similar symptoms to astute metatarsal fractures (higher up), although there is ordinarily no bruising and no peachy sound.
• At start, the main symptom may just exist pain in the pes during exercise that is relieved by remainder. The hurting tends to be widespread and diffuse in the foot.
• After a while, the pain may become continuous, then that information technology is not relieved past resting. The sore area tends to become more localised to the area of the fracture, and the pain gradually increases.
• Typically the stress fracture causes a tender area along the line of the second or third metatarsal bone.
• There may be some swelling merely at that place is normally no bruising.

People who have stress fractures may continue to walk for some time. Eventually this becomes increasingly painful, as the splits in the bone tend to worsen and the bone itself starts to react and become inflamed, and it can become incommunicable to weight bear. A metatarsal stress fracture tin can progress to go a full-thickness fracture.

Will the pain increase?

Metatarsal stress fractures tin begin as very small injuries which do non cause severe hurting. Even so, if y'all carry on stressing the os, the crack will often deepen and widen, condign gradually more painful. Eventually, in the worst case scenario, the stress fracture may progress to get a full fracture.

If you have an acute fracture and you continue to stress the bone, the pain volition increase further every bit the broken ends of bone will start to rub slightly against one some other, and the area will become inflamed. In the worst case scenario the fracture may become displaced.

Do I need whatever investigations?

Your doctor is likely to advise an 10-ray of your foot if they suspect a metatarsal fracture.

Astute metatarsal fractures

• Most can exist seen easily on Ten-ray. Initially doctors can meet the crack in the bone, and after a few days they tin can also meet irregularities in the os as it starts to heal and remodel itself.
• Computerised tomography (CT) scanning or magnetic resonance imaging (MRI) scanning is occasionally needed.
• The doctors will demand to make up one's mind if the fracture is displaced, which may mean that the bones need to be re-aligned and held in place. This is quite common in astute metatarsal fractures, as the weight of your body tends to push downward on the broken bone and this tin can forcefulness the two broken ends slightly apart.

Stress fractures

• Practise not show upward as hands on Ten-ray, peculiarly not at first. One-half of them never prove up on a normal Ten-ray.
• There tin can be multiple, very tiny fractures and splits in the bone, or simply one fine crack which doesn't get correct through the bone. Because they have formed very gradually, the os may not have 'reacted' very much to the injury.
• A specialised ultrasound scan may show a fracture that can't exist seen on X-ray.
• Metatarsal stress fractures tin can usually be seen by using a bone scan.
• MRI scanning is also sometimes used to find stress fractures.

Do I need to see a medico if I suspect metatarsal fracture?

You should seek medical advice if you suspect that you take a metatarsal fracture. A doc is able to do tests, including imaging, which will suggest the best course of action - not simply to make things meliorate equally chop-chop as possible, but too to prevent making things worse.

How are metatarsal fractures treated?

This depends on:

• Which metatarsal bone is broken (fractured).
• Which part of the metatarsal os is broken.
• How severe the damage is.
• Whether information technology is an astute fracture or a stress fracture.

It also depends on:

• Whether the fractured bone is displaced or non-displaced (see above).
• Whether the tissues of the foot effectually the intermission are also badly injured causing the fracture to be an open fracture.

The basic principles of treating metatarsal fractures are as follows.

Simple painkillers

Painkillers such as paracetamol and not-steroidal anti-inflammatory painkillers such equally ibuprofen which may help to relieve pain.

Ice

Applying ice to your human foot tin also be helpful every bit pain relief. Ice should be applied every bit soon equally possible subsequently injury, for x-xxx minutes. (Less than x minutes has little outcome. More than than 30 minutes may impairment the skin.) Make an ice pack by wrapping water ice cubes in a plastic bag or towel, or by using a handbag of frozen peas. Practise not put ice directly side by side to skin, as it may crusade ice burn. Gently press the water ice pack on to the injured part. The cold is thought to reduce blood flow to the damaged area. This may limit hurting, inflammation and bruising. Some doctors recommend re-applying for fifteen minutes every ii hours (during daytime) for the first 48-72 hours. Do not leave ice on while comatose.

Meet the separate leaflet called Heat and Water ice Treatment for Hurting for more details.

Rest and drag

Height initially aims to limit and reduce whatsoever swelling. For example, keep the pes up on a chair to at to the lowest degree hip level when you are sitting. When you lot are in bed, put your human foot on a pillow. Sometimes residuum is the only treatment that is needed, even in traumatic fracture.

Stop stressing the human foot

If you've been diagnosed with a stress fracture, avoiding the activity that caused it is important for healing. This may mean using crutches or fifty-fifty a wheelchair.

Immobilisation

Some fractures only need support to help healing. For example, a supportive elastic tubular bandage with a supportive, rigid shoe or boot. If needed, special shoes are available to aid to immobilise the fracture and support the pes so that you are able to walk. Progressive weight bearing on the human foot tin then follow as pain allows. Other fractures may need treatment with a below-the-knee plaster cast.

Surgery

Very occasionally, surgery may be necessary - for example, to re-align any part of the bone that has moved out of position. Surgery is not needed for stress fractures.

Follow-up intendance

Physiotherapy and a gradual render to exercise are a part of skilful follow-upwardly care.

When can I return to activity after metatarsal fracture?

• Acute metatarsal fractures by and large take effectually six to eight weeks to heal. However, it may exist longer than this earlier a sportsperson is fully back in activeness.
• Stress fractures unremarkably heal without any complications and, in time, people are able to return to their previous activities fully. You lot tin can return to your activities when you tin perform them without hurting. This will typically take vi to twelve weeks. When you do showtime exercising once more, yous should gradually build up your action levels. A sudden return to high-intensity practice afterward a suspension may crusade a repeat or a new stress fracture, or other injury.

What if the hurting gets once more worse?

If the pain gets worse then yous should seek medical advice. The expected blueprint of healing, in bony injuries of any kind, is that they should gradually hurt less as healing occurs, and that any gradual worsening of pain suggests that the injury is also getting worse, or that you have a fresh injury.

If your human foot pain is increasing over time then your activity may be making an existing trouble worse. In the case of a stress fracture this may mean progression to an acute fracture. In the case of an acute fracture information technology may exist worsening displacement of the bones and preventing the 2 ends of the bone from knitting together. Ever return to your doctor or health professional person for further communication if you take gradually worsening symptoms.

What are the complications of metatarsal fractures?

If properly treated then metatarsal fractures should heal without long-term consequences. If not recognised and treated then some of these problems tin can occur:

• A metatarsal stress fracture can become gradually worse if repeated stress to the bone continues. It tin can somewhen become a total-thickness metatarsal fracture.
• A fracture of the first metatarsal bone can pb to later arthritis of the big toe articulation.
• A fracture at the base of operations of the fifth metatarsal bone is frequently mistaken for an ankle sprain and therefore not rested or supported enough. This can lead to problems in healing and standing pain.
• A full-thickness fracture which is displaced and non 'put back' into line can heal 'out of shape', leading to deformity of the foot, sometimes making shoe plumbing fixtures difficult. The foot may exist painful.
• Acute metatarsal fracture tin likewise, occasionally, lead to 'non-union', which is when the two ends of cleaved os terminate trying to heal because movement betwixt them makes this impossible. This may pb to reduced power of the pes to cope with stresses and strains of walking and running and it may also lead to chronic pain in the foot.

Can metatarsal stress fractures exist prevented?

There are a number of things that you can do to assist forbid stress fractures:

• Exercise intensity and duration should be built upwardly slowly and gradually.
• Rest time and recovery time need to be built in to any training schedule.
• Footwear should be well fitting and suit your running style. If changing - for instance, from supportive training shoes to barefoot running shoes - you should be shown how to adapt your style. You should practise this gradually.
• You should be aware of the symptoms of stress fractures, and should not continue to run on a painful foot.

If stress fractures are recognised and treated quickly, this can reduce the corporeality of fourth dimension that you need to stay away from activities.

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Source: https://patient.info/foot-care/heel-and-foot-pain-plantar-fasciitis/metatarsal-fractures

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