Fracture of the second metatarsal bone of the foot how long it heals. Metatarsal bone of the foot: fracture treatment

In traumatology, a fracture of the metatarsal bone of the foot is rare. Without a thorough diagnosis, the condition can be confused with a bruise or sprain, since the symptoms are similar: swelling, hematoma, severe pain, difficulty supporting the leg. Treatment should be taken seriously, since the injury is dangerous with complications in the form of deformation of the bones of the foot, chronic pain, arthrosis. Therefore, after an accident, consultation and examination by a doctor is recommended.

Why does a metatarsal fracture occur?

According to ICD 10, damage has the code S92.3. The condition appears due to injuries or stress on the joints during prolonged stress on the legs. A fracture of the bones of the human foot occurs due to such reasons:

falling from a height or jumping with an emphasis on the feet;
extreme and strength sports;
professional activity associated with regular weight lifting or a heavy load on the legs;
narrow uncomfortable shoes;
industrial and road accidents;
a direct blow to the foot with a heavy blunt object.

How to recognize trauma?

The most common fracture is the 5th metatarsal of the foot. Damage is distinguished as closed without displacement, in which the integrity of the skin is not violated. An open type of injury with a displacement is characterized by fragmentation of the bone into fragments that cut through the skin and form a wound. An injury to the base of the fifth metatarsal bone provokes, in which the fracture line is located in the articular cavity. In children and adults, the following symptoms are observed:

strong sharp pain when you try to lean on your leg or put pressure on the site of the bruise;
puffiness;
hematoma;
crunch heard at the time of injury;
shortening of the finger where the fracture occurred;
lameness or inability to lean on the leg;
local increase in temperature;
nausea and dizziness, as a reaction of the body to pain.

What are the complications?

The fracture is differentiated with dislocation.

With an open fracture, there is a risk of penetration into the wound pathogenic microorganisms- tetanus or Pseudomonas aeruginosa, staphylococci, streptococci, which provoke sepsis and cause a life-threatening condition. Fractures of the bones of the foot often resemble a bruise in symptoms, so the victim does not immediately go to the doctor. An untimely detected injury of the 3rd-4th and 5th metatarsal bones entails such consequences as:

chronic pain;
change in the structure of the bone body;
limited movement;
lameness;
the bone does not grow together or the union does not work properly;
arthrosis;
the appearance of bone calluses, which degenerate into a false joint.

Diagnosis and treatment

Before being taken to the emergency room, the victim must be given first aid. To do this, apply cold compress on a broken foot, and in case of an open injury, it is recommended to treat the wound with hydrogen peroxide. Transport immobilization in case of a fracture, it is carried out in a sitting or lying position, providing the limbs with complete rest.

The diagnosis is made by a traumatologist or orthopedic surgeon based on the patient's complaints, trauma history, visual examination, and radiography. A complete clinical picture is shown by a picture in 3 projections, where you can see the nature of the fracture - open or closed, the degree of damage to the metatarsal bone and surrounding tissues. In severe cases, scintigraphy, ultrasound, CT, MRI are prescribed.

Therapeutic measures

The fifth metatarsal bone is poorly supplied with blood, so fusion takes a long time, requires long-term therapy and limited emphasis on the limb.

Metal synthesis is a common method for joining fragments.

At closed damage the leg is immobilized with a plaster cast. You can only move with the help of crutches. Fracture treatment open type carried out in a hospital. The doctor cleans and drains the wound, removes dead skin particles, sets the bones, fixing them, if necessary, with metal synthesis tools: pins, plates, knitting needles, bolts. Then he sews up the wound, shifts the seam with a sterile napkin and applies plaster. During the period of wearing the fixator, bed rest is recommended to avoid recurrence of displacement of fragments. Control radiographs are also recommended.

Rehabilitation after a fracture

Physiotherapy

The recovery period may take several months depending on the severity of the damage. After removing the cast, heavy physical exertion on the leg is prohibited. If walking cannot be avoided, emphasis should be placed from heel to toe. Exercise therapy for a fracture helps develop the metatarsal bones. The following exercises are effective:

Circular foot rotations.
Clenching and unclenching fingers.
Turning the feet up and down and from side to side.
Rolling a ball placed under the foot.

After a full recovery, patients should avoid re-injury, limit physical activity (at least for a while) and remember to take precautions.

Causes

The victim needs to seek qualified help as soon as possible.

Fracture of the metatarsal bones of the foot is classified into two main types:

Signs of a broken foot

Then the traumatologist will examine the injured leg, after which the patient will be examined in the x-ray room. Based on the picture of the metatarsal bone and the data received from the patient, the doctor makes a conclusion about the nature of the fracture and prescribes further treatment.

The bone breaks with a crunch;

In the area of the fifth metatarsal bone, fractures can also occur in the middle part of the bone, as well as fractures of its neck or head.

First aid

Cons:

Elevated position.

Diagnostics

In case of fractures without displacement, a posterior plaster splint is applied to the sore finger. In the presence of displacement, there is a need for a closed reduction. Fragments of bones are fixed with knitting needles.

The danger is that most people with such an injury are in no hurry to see a doctor, often the person does not even suspect that he has a broken foot. The signs in this case are not as pronounced as in other fractures, the patient walks and steps on his foot. Therefore, in order to avoid complications, it is necessary to consult a doctor immediately.

Fracture of the talus

Plaster is applied for a month and a half. Starting from the third week, you need to release the injured limb from the splint and make active movements with the ankle joint.

Foot fracture is a fairly common injury and accounts for up to 20% of all bone fractures. You should not take this lightly, the consequences can be very negative, up to the inability to move around without outside help.

. Lack of proper treatment can cause improper fusion of the fifth metatarsal bone. In the future, such an injury can be cured only with the help of surgery and a long rehabilitation period.

Traumatic nature (open or closed), associated with the receipt of a particular injury, for example, a direct blow or dislocation of the foot;

In case of damage to the metatarsal bone without displacement, plaster immobilization, the purpose of which is to provide maximum rest to the injured leg, thereby protecting the damaged bone from displacement.

The appearance of a pain symptom after an injury;

Fractures of the fifth metatarsal bone can be without displacement (the anatomical ratio of the bone fragments is not disturbed) and with displacement (there is a separation of the bone fragments and their incorrect position), as well as closed (the skin on the foot is not damaged) and open (the presence of a wound communicating with the area fracture). With fractures with displacement, there is a danger of improper union of fragments, as well as non-union. With open fractures, the risk of developing infectious complications increases: suppuration, phlegmon, osteomyelitis, tetanus.

the ends of the pins remain above the skin so that the pin can be removed after the fracture heals; the risk of infection of the wound and the penetration of infection into the fracture area; prolonged wear plaster cast 1 month; inconvenience in everyday life.

Give injured leg exalted position, for example, resting your foot on a pillow while lying on a couch or bed. If you are sitting, you can put your foot on a chair, this will reduce swelling and pain.

Fracture of the scaphoid

Fractures of the nail phalanges do not need special treatment, usually fixation with an adhesive bandage is sufficient. The immobilization period is from 4 to 6 weeks.

A fracture of the fifth metatarsal bone of the foot is an injury that occurs most often.

Somewhat later, physiotherapy exercises and massage, physiotherapy are prescribed. It takes two to three months to restore working capacity.

This injury can occur if the foot is twisted sharply in any direction, jumping from a height with emphasis on the legs, or when hit by a heavy object.

Patients with a fracture of the metatarsal bone, including the fifth, are waiting for an examination by a traumatologist or orthopedist. As a rule, in addition to examining symptoms and clinical manifestations foot and ankle, as well as studying the patient's complaints, the specialist will prescribe an additional study.

Fatigue (cracks in the bones) associated with prolonged and systematic stress on the metatarsal bones of the foot, for example, among active pastime enthusiasts or athletes, as well as in people who constantly use uncomfortable, tight shoes.

Fractures of the cuboid and sphenoid bones

If the displacement is insignificant, the doctor repositions the damaged metatarsal bone, after which he applies a plaster cast or splint.

Fracture of the metatarsal bones of the foot

visually noticeable shortening of the finger or change in its position;

Traumatic fracture

Swelling and pain when touched on the outer edge of the foot;

Open reposition for fracture of the metatarsal bone of the foot, plate osteosynthesis plate and screws. The operation includes a surgical incision, access to the broken metatarsal bone, gently retracting tendons, vessels and nerves, mobilization of bone fragments, elimination of displacement and fixation in the correct position.

Excluded:

Fracture stress (fatigue)

If you properly treat a foot fracture and strictly follow all the doctor's recommendations, it is possible not only to shorten the recovery period, but also to prevent possible complications.

Turning the foot inward may cause an avulsion fracture. When this occurs, the separation and displacement of the metatarsal bone. Splicing is very long, so you need to contact a traumatologist as soon as possible. At untimely treatment the bone may not heal properly, in which case surgery will be needed.

Occurs as a result of direct impact. Often, a fracture of this foot bone is accompanied by injuries to other bones.

Metatarsal fractures occur as a result of an unexpected strong impact on the leg, excessive load and overstrain.

In this case, the most informative methods may be:

Depending on the location, the presence of displacement, as well as the type of injury received, fractures can occur in the body or base of the metatarsal bone and are divided into: comminuted, helical, transverse or oblique.

If a transverse or oblique fracture with a significant displacement is detected, the doctor prescribes an operation, during which all bone fragments will be put in place and fixed with a plate and screws. In this case, a plaster cast is not applied, since the damaged bones are securely fixed. In addition, the patient

Swelling and hematoma, often manifesting only the next day.

Diagnosis of a Metatarsal Fracture

pain when walking;

Treatment

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

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

Patients with these symptoms typically experience a sudden onset of sharp, intense pain after an injury. Sometimes the patient may hear a crackling or clicking sound at the time of the injury. The pain causes the patient to limp. Patients with metatarsal fractures also have swelling that increases during the day and decreases at night. In severe fractures of the metatarsal bones with displacement, the obvious deformity may not be noticeable.

The base of the 5th metatarsal is an area with poor blood supply. This is where the Jones fracture occurs. It appears in the background stress loads and grows very slowly.

Symptoms

Swelling of the injured area and pain are the very first symptoms that indicate that you may have a broken foot. The photo below shows what a sore leg looks like.

X-ray scanning in two projections;

Often, a fracture of the metatarsal bone of the foot is combined with some other specific diseases, such as osteoporosis or deformity of the feet. The most common fracture of the fifth bone, which can later be displaced.

Fractures of the phalanges of the toes

allowed to step on the heel a little

For fatigue are most characteristic

the appearance of bruising;

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

It is important to limit the load when walking (do not lean completely on the foot) until the damage is diagnosed by a doctor.

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

The victim is carefully examined by a doctor, studying not only the foot, but also the ankle joint, determines the presence of edema, hemorrhage and characteristic deformity. Then a radiograph is taken in direct, lateral and semi-lateral projections. After determining the fracture and its type, the necessary treatment is prescribed.

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Fracture of the metatarsal bone of the foot, symptoms, treatment, rehabilitation | Fracture of the fifth metatarsal

A person cannot lean on a limb due to strong pain. There is swelling and hemorrhage. On palpation, attempts to turn the foot in and out, the person feels a sharp pain. To confirm a fracture scaphoid feet, it is recommended to conduct an x-ray examination.

Diagnosis of metatarsal fractures

Painful sensations can be so strong that a person cannot move. Bruising may also occur in the area of injury. A displaced fracture is characterized by a change in the shape of the foot.

CT scan;

Less often, but still, marching fractures of the metatarsal bone are also encountered. Treatment in this case may also require a long time, especially if the injury is old.

Where to apply As soon as the fracture of the metatarsal bone grows together and the pain decreases, the doctor will allow you to step on the foot in a dosed manner, gradually increase the load.

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

First aid for metatarsal fractures

Stress fractures are usually associated with an increase in the intensity or duration of repetitive movements such as running, ballroom dancing, etc. If a minor foot fracture is found, the treatment is a simple splint. In this case, the injured limb must be immobile for several weeks in order for the damaged bone tissue to heal completely.
Treatment Sometimes a person does not realize that he has a broken foot. Signs may not be pronounced, pain occurs only when the load on the affected leg. Therefore, to clarify the diagnosis, it is necessary to contact a traumatologist.
Magnetic resonance imaging. The most common causes that provoke these fractures include systematic intense sports activities, weakening of the bones as a result of osteoporosis, road accidents, falls from a considerable height or heavy objects falling on the foot.
Also in such cases, a doctor may prescribe percutaneous fixation with knitting needles. During this procedure, the doctor first sets the fragments into place, and then with the help of knitting needles fixes the damaged metatarsal bone in various directions. Currently, this method is considered the most popular. Which is not surprising - it does not require an operation, practically leaves no marks on the skin. After the procedure, a plaster cast is applied. This procedure also has its drawbacks - the ends of the needles are above the surface of the skin, which causes a number of inconveniences. Pain during physical activity especially running. This pain often goes away with rest but reappears with increased activity.

Any person with symptoms of a fifth metatarsal fracture should see an orthopedic trauma professional as soon as possible for correct diagnosis and treatment. Do not self-medicate!

The goal of any treatment for metatarsal fractures

Treatment of fractures of the metatarsal bones of the foot

Conservative treatment of mold bone

Inspection:

When the bone is severely damaged, internal fixation is necessary. This is done using special screws. If no displacement is found, the doctor applies a circular plaster cast to the damaged area. In case of fractures of the navicular bone with displacement, bone fragments are compared; in some cases, an open reduction may be necessary. The foot is fixed with plaster for a period of four to five weeks.

If a fracture of the bones of the foot is suspected, the injured limb must be fixed. You can use an impromptu splint made from boards, ski poles or rods, which is attached to the leg with bandages. If nothing is at hand, you can bandage the injured limb to a healthy one using a scarf, shirt or towel.

Treatment after diagnosis will be selected depending on the presence of displacement, the location of the fracture, and also taking into account open or closed type injury. With mild and minor injury, patients may be shown only a short fixation of the limb with a splint. Sometimes a few weeks are enough for healing to occur and the fracture to be cured.

In practice, the most common fractures are the fifth, second and first metatarsal bones, which are the most common among other types of this injury.

When a stress fracture is diagnosed, a cast is not applied. In this case, it is recommended to minimize the load on the affected leg, including when walking. Also, the doctor will recommend orthopedic insoles that will help relieve excess stress from the injury site.

pain localized at the site of injury;

Metatarsal fracture surgery

If it is not yet possible to contact an orthopedic surgeon, the following recommendations should be followed:

Percutaneous fixation with wires

help the patient return to full life. Following the recommendations of the doctor will help to quickly restore the function of the foot and prevent further problems in the future.

Careful examination and study of the entire foot and ankle joint plays an important role in the identification of concomitant lesions. Deformity, swelling and hemorrhage are visualized without difficulty. The severity and nature of the damage determines further treatment. Any non-displaced metatarsal fracture needs to be immobilized. The applied gypsum will reliably protect the bone from possible displacement. Due to the fact that the foot is completely immobile, accretion bone tissue will happen faster.

It is quite difficult to treat such a fracture of the foot in combination with a dislocation. If the dislocated fragment is not put back into place, traumatic flat feet may develop. The displaced fragments are adjusted using a special pulling apparatus. Sometimes it is necessary to resort to an open reposition and fixation of the reduced fragment with a silk suture. After such a procedure, the immobilization of the injured limb should last up to 10-12 weeks. In the future, it is necessary to wear orthopedic shoes. With an open fracture, you should not try to set the bone yourself, first of all, you need to stop the bleeding. To do this, treat the skin around the wound with iodine or hydrogen peroxide. Then you need to carefully apply a sterile bandage. After first aid has been provided, the victim must be taken to a medical facility.

Open reposition of the fracture

During treatment, the patient is shown complete rest, the sore leg should not be loaded, movement is possible only with crutches.

They are accompanied by the following symptoms:

In all cases of applying a plaster cast

Rehabilitation after a metatarsal fracture

Swelling in the area of damage without hematoma.

Keep the injured foot at rest, as walking can worsen the situation; Make a diagnosis and prescribe proper treatment only a doctor can. If you have any questions, you can call

We are convinced that for non-displaced fractures, adult patients do not need to apply a cast, as this causes a lot of inconvenience, and they are able to understand that they need to limit the load in order to quickly heal the fracture. Displacement of bone fragments does not occur without load. But it is difficult for our young patients to explain that one should not step on the foot or walk only with support on the heel. Therefore, we plaster children.   If during the injury there was a displacement of fragments, surgical intervention is indispensable. During the operation, the doctor opens the fracture area and compares the resulting fragments, after which it fixes them with special knitting needles or screws. Then plaster is applied for up to six weeks. The patient is forbidden to step on the injured leg. You can start walking after six weeks. The spokes are removed after three months, the screws after four. The patient is advised to wear orthopedic shoes or insoles.

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Fracture of the 5th metatarsal

Most often, the injury occurs when a weight falls on the rear of the foot and is accompanied by swelling of the soft tissues in the area of injury, pain on palpation and turning the foot in any direction. An x-ray is required to confirm the fracture. After that, the leg is fixed with a plaster cast for a month and a half. For a year after such a fracture, it is recommended to wear an arch support. First of all, the traumatologist should carefully examine the sore leg. Having found symptoms of a broken foot in the victim, the doctor takes an x-ray to determine the type and location of the damage. Very rarely, there is a need for computed or magnetic resonance imaging. As for open fractures and fractures with displacements, the treatment in this case will be more intensive and longer. Immobilization is also required, as it provides fixation of the displaced bone and prevents its further displacement. Sometimes the question of the expediency of surgical intervention is resolved. During it, internal fixation of the damaged bone is often carried out - special screws are used for this.

The formation of edema on the plantar part of the foot, sometimes spreading to the region of neighboring tissues and to back side feet;

The period of wearing is determined by the attending physician

Types of fractures of the 5th metatarsal

If symptoms of a stress fracture have been diagnosed,

apply cold to the foot;

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

Signs of a fracture of the 5th metatarsal:

X-rays in 2 projections are usually enough
With a Jones fracture, a plaster bandage is applied from the toes to the middle third of the lower leg for up to two months. You can not step on an injured leg.
This injury is the most common among all foot fractures. There are two types of metatarsal fractures: traumatic and stress.

After a fracture has been diagnosed, treatment is prescribed, which depends on its type and on which particular bone is broken.

Lack of treatment can lead to various backfire, for example:

Treatment of a fracture of the 5th metatarsal

The presence of strong and fairly intense pain;

. It is not recommended to remove it ahead of time - this can lead to a number of complications. varying degrees severity, including nonunion of the fracture.
you need to see a doctor as soon as possible
To reduce swelling and pain in the foot, wrap an ice pack in a thin towel and apply to the injured area for 20 minutes every hour. do not apply ice directly to the skin.
ask a question by email.
In case of stress fractures, it is recommended to walk with a partial load on the foot, but always in individual orthopedic insoles that “unload” the damaged area.

Methods of treatment of fractures of the fifth metatarsal bone

to diagnose a fracture. But with stress fractures without displacement, sometimes they cannot be identified even by a very experienced doctor.
To reduce the load on the injured limb while walking, you need to use crutches. The patient must be observed by a doctor who will choose the right rehabilitation course to restore impaired functionality in the injured foot.

Features of the treatment of a Jones fracture

It is the result of external mechanical action. This can be a fall of gravity on the leg, squeezing the foot, a strong blow.

This bone has some special features. No muscle is attached to the talus. In addition, it transfers body weight to the entire foot.

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Signs and manifestations

wound infection in open fractures and the development of various infectious diseases as a result of the ingress of pathological flora from the outside;

hematoma formation as a result of subcutaneous hemorrhage;
Like any other fracture, a foot fracture can cause a number of complications. First of all, it is a deformity of the foot of varying severity, leading to a limitation of its mobility and, accordingly, inconvenience when wearing shoes. One of the most common complications is chronic pain at the site of injury. Also, arthrosis can occur in the area of \u200b\u200bconnection of broken bones. And in the case of a fracture with a displacement, angular deformation may occur if the necessary correction of the fragments has not been made. If the fracture does not grow together for a long time, such a complication is treated with an operative method.
. With symptoms of a traumatic fracture, the victim needs first aid and an urgent appeal to a specialist.
bandage the foot with an elastic bandage or put on compression stocking to prevent the development of edema;

Modern foot surgery is often faced with variousIf there is a fracture of the metatarsal bone with a slight displacement, an attempt is made to reposition and fixation with a plaster splint.

In such cases, control radiographs are prescribed after 10-14 days, when bone tissue resorption occurs at the fracture site. Also, stress fractures are difficult to see on x-rays until they begin to heal and form. callus. It is very visible on x-rays. Computed tomography or MRI may be needed to rule out a stress fracture and other foot pathologies.
The recovery period for a fracture of the metatarsal bone is quite long and includes physical therapy, massage, the use of arch supports, and physiotherapy.
Signs

Fracture of the talus is possible as a result of indirect trauma, occurs infrequently and is considered heavy damage foot bones. Accompanied by other injuries, such as a fracture, dislocation of the ankle or other bones of the foot. non-fusion of the injured metatarsal bone; Pain and discomfort when stepping on an injured lower limb;

First aid

After the x-ray shows that the fracture has completely healed, the doctor will allow you to step on the injured leg. Most often this happens no earlier than a month and a half later.

If there is the slightest suspicion of a fracture of the bones of the foot, the victim must be given first aid and taken to the hospital, since he most likely will not be able to get there on his own with such an injury.

Elevate your foot to reduce swelling keep the foot at hip level or slightly higher. Fractures of the 5th metatarsal If the fracture is accompanied by a significant displacement of bone fragments (more than half the width of the metatarsal bone), the question of surgery is decided.

What treatment is given

Limitation of loads and movements.

If such an injury is not treated or treated incorrectly, then complications such as arthrosis, deformity, constant pain and nonunion of the fracture.

A traumatic fracture of the foot manifests itself with a characteristic crunch and pain at the time of injury, you can notice a shortening of the toe or its deviation to the side. The pain is very strong at first, but weakens over time, although it does not go away completely. Swelling or bruising occurs at the site of injury.

Symptoms

deformity of the injured foot; The presence of a characteristic click or crunch immediately at the time of injury; It is very important to dose the loads

How to help the victim? First of all, he needs to be given pain medication. A person needs to be provided with complete rest, it is impossible not only to stand up on the injured leg, but also to lean on it. The injured foot must be securely fixed, for which a splint is applied. If there are no special devices at hand, a regular board will do, which must be fixed to the foot at the site of injury. If possible, it is also necessary to immobilize the leg at the ankle.

Immobilization of the foot with a plaster cast. Crutches are used to eliminate the load on the foot.

, which is located along the outer edge of the foot. Clinical picture damage is characterized by swelling of the foot and pain in the area of injury localization. The indication for surgery for a fracture is the displacement of fragments of the metatarsal bone by more than half the width of the bone. It is important to limit movement and load on the foot to prevent further damage.

Complications after treatment

This type of foot fracture is possible as a result of direct impact on the toes (for example, with a strong blow or heavy fall). If the main phalanges do not grow together correctly, the function of the foot may be impaired. In addition, there may be pain when walking and limited mobility of the injured limb. As a result of a fracture of the middle and nail phalanx such consequences do not occur.

Recovering from an injury

Such injuries, which include a fracture of the 5th metatarsal, are commonly seen in athletes and those who lead active image life. They appear as a result of excessive and prolonged stress on the foot. In fact, such a fracture is a crack in the bone, and it is very difficult to notice it. sharp pain, there is swelling of the foot and ankle, hemorrhages are noticeable on the skin. If the fragments are displaced, you may notice that the foot is deformed. Chronic pain.

the presence of bleeding and tissue damage in open fractures;

- at first it is better to walk, stepping only on the heel, gradually increasing the load on the entire foot. The doctor will also suggest a set of exercises that will help restore motor function legs. If pain occurs, any exercise must be stopped.

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Fracture of the metatarsal bone of the foot: symptoms, treatment

Types and causes of injury

Surgery for a fracture of the 5th metatarsal may be required if there is displacement, multiple fractures of other bones in the foot, or if there is no union. The operation consists in precise comparison of bone fragments and their reliable fixation with the help of mini-implants.

The nature of the fracture is determined by the type of injury that has occurred. The fifth metatarsal is more likely than the other metatarsal bones to be subject to an indirect mechanism of injury as a result of foot tuck.
It has been popular for many years and continues to be one of the most popular methods internationally.

Cold locally.

Symptoms

If a person suffers from various comorbidities, such as osteoporosis or deformity of the feet, his condition may worsen significantly. A stress fracture of the metatarsal bone also occurs in those who constantly walk in uncomfortable and tight shoes.

To confirm the fracture, determine its location, type and degree of displacement of the bones, an x-ray examination is performed in two projections.

Symptoms and characteristic manifestations of trauma

After bone fusion, treatment is not completed,

Lameness when walking, provoked by pain;

It is best to supplement the rehabilitation course with swimming - this will help to most effectively restore all leg functions with minimal loads. Also, the patient can be prescribed exercise therapy, massage and various physiotherapy procedures.
manipulations must be carried out with the utmost care.
As with other fractures of the fifth metatarsal, a cast immobilization may be performed, but the duration is usually longer because this type of fracture heals more difficult.
Fractures of the fifth metatarsal bone can be in the area of its base, middle part and head.
First, the doctor closes the displacement of the fragments, then the needles are drilled through the fragments in certain (given the nature of the fracture) directions.
Using ice will help slow down or reduce swelling and provide a feeling of numbness that will relieve pain. It makes sense to apply ice to the injury site during the first 48 hours after the injury. Never keep ice for more than 20 minutes at a time to prevent frostbite. Rest 1.5 hours before re-exposure to ice, this allows the tissues to return to normal temperature and trophic, repeat as needed. You can wrap any frozen product in a towel and apply to the injury site. Ice should be applied as soon as possible after injury. (Don't put ice directly on your skin. Also, don't leave ice on while you sleep for more than 30 minutes. It can cause frostbite.)
There is cyanosis of a broken finger, swelling, pronounced soreness during movement. With such injuries, a subungual hematoma is sometimes formed. To confirm the diagnosis, it is recommended to conduct an x-ray examination in two projections.
Symptoms

How to treat In the future, the patient expects a rehabilitation period The formation of a characteristic deformity of the foot.

Diagnosis and treatment

Full recovery usually occurs one month after the removal of the cast. During this time, the bone becomes as strong as before, and atrophied muscles restore their functions. To strengthen the bones from the inside, it is recommended to take special vitamin complexes not only during treatment and rehabilitation, but also in the future.

due to the risk of increased damage. Ice can be applied to the injury site for 10 minutes every hour and a half to relieve swelling and reduce pain.

Bone stimulation is used to speed up the healing of some fractures.
An avulsion fracture of the base of the 5th metatarsal is an injury in which a bone fragment is torn off under the action of the tendons attached to it. This type of fracture occurs when the foot is turned inward. Avulsion fractures are often missed when they accompany an ankle sprain.
Pros:

Elastic bandage.

Treatment

The first symptom that should alert you is pain that occurs in the foot after a long intense load and disappears in calm state. Over time, it intensifies to such an extent that any action becomes impossible. Pain persists even at rest. Edema appears at the site of the injury.

If a displaced foot fracture is diagnosed, the bone fragments are matched immediately. The fact is that the later you see a doctor, the more difficult it will be to restore their correct position, sometimes even impossible.

. Through activities such as physiotherapy, physiotherapy, massotherapy, the use of instep supports is possible full recovery, the return of mobility and functionality of the foot. In most cases, the prognosis is favorable and the patient manages to return the quality of life and the ability to move normally.
If these symptoms appear and a fracture is suspected,
In the life of every person there are unpleasant moments associated with various diseases and injuries, including lower extremities. A typical injury is also considered to be a fracture of the metatarsal bone of the feet. It is quite common among athletes, although almost everyone can get it, regardless of their physical activity. This fracture cannot be determined independently, as well as treated at home. Only an experienced specialist (traumatologist or orthopedist) will be able to accurately determine the location of the fracture, its nature, and prescribe adequate treatment.
For staging the most accurate diagnosis the traumatologist will first find out from the victim under what conditions the injury was received - in what place the blow fell, with what force the mechanism of injury itself was. Similar Symptoms with a fracture, they also have injuries such as bruising of the foot and sprain of the ligaments of the foot.

The symptoms of traumatic and fatigue, or, as it is also called, marching, fractures are different. So, in traumatic, the following symptoms are characteristic: Jones fracture occurs in the area of the base of the fifth metatarsal bone, in an area with poor blood supply. Therefore, often with such fractures, delayed union and nonunion of the fracture are noted. As a rule, a Jones fracture occurs against the background of previous cyclic stress loads.

You need to wrap your leg with an elastic bandage. But bandage correctly, not too tight. If the fingers become cold, there is numbness, then the bandage is too tight. An elastic bandage will limit swelling and restrict movement in the joint. You can sleep without a bandage. But be sure to move around by bandaging your leg with an elastic bandage.

Moisov Adonis Alexandrovich

Orthopedic surgeon, doctor the highest category

Moscow, Balaklavsky prospect, 5, Chertanovskaya metro station

Moscow, st. Koktebelskaya 2, bldg. 1, metro station "Dmitry Donskoy Boulevard"

Moscow, st. Berzarina 17 bldg. 2, metro station "October field"

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Education and professional activities

Education:

In 2009 he graduated from the Yaroslavl State medical academy majoring in medicine.

From 2009 to 2011, he completed clinical residency in traumatology and orthopedics at the clinical hospital ambulance medical care them. N.V. Solovyov in Yaroslavl.

Professional activity:

From 2011 to 2012, he worked as a traumatologist-orthopedist at the emergency hospital No. 2 in Rostov-on-Don.

Currently works in a clinic in Moscow.

Internships:

May 27 - 28, 2011 - Moscow- III International Conference "Surgery of the Foot and Ankle" .

2012 - training course in foot surgery, Paris (France). Deformity correction anterior section feet, minimally invasive surgery for plantar fasciitis(heel spur).

February 13-14, 2014 Moscow - II Congress of traumatologists and orthopedists. “Traumatology and orthopedics of the capital. Present and Future".

June 26-27, 2014 - took part in V All-Russian Congress of the Society of Hand Surgeons, Kazan .

November 2014 - Advanced training "Application of arthroscopy in traumatology and orthopedics"

May 14-15, 2015 Moscow - Scientific and practical conference with international participation. "Modern Traumatology, Orthopedics and Disaster Surgeons".

2015 Moscow - Annual international conference.

May 23-24, 2016 Moscow - All-Russian Congress with international participation. .

Also at this congress he was a speaker on the topic Minimally invasive treatment of plantar fasciitis (heel spurs) .

June 2-3, 2016 Nizhny Novgorod - VI All-Russian Congress of the Society of Hand Surgeons .

June 2016 Assigned . Moscow.

Scientific and practical interests: foot surgery and hand surgery.

metatarsal bones are part of a group of small tubular bones of the human skeleton. Metatarsal fractures are the most common foot fractures. Namely, fractures of the base of the fifth metatarsal, resulting from inversion of the foot. The localization of the fracture should be carefully analyzed by the doctor, since the treatment of fractures with different localization 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 mid and forefoot.
Stress fractures - due to excessive prolonged load or repeated minor injuries against the background of completely normal metatarsal bones.

Also, fractures of the metatarsal bone of the foot are classified according to localization, the nature of the fracture and the presence of displacement:

Fractures of the base, body or subcapitate fractures of the metatarsal bones;
Metatarsal fractures 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 foot anatomy.

The human foot is made up of 26 bones:

5 metatarsals. These are tubular bones that are located between the bones of the tarsus and the phalanges of the fingers. Functionally, the metatarsal bones play important role in motion, acting as a lever during foot movements (steps, running, jumping).
14 phalanges of fingers. The first finger consists of two phalanges, the other fingers - of three.
3 sphenoid bones. located between scaphoid and the first three metatarsals.
Cuboid
Scaphoid
Talus
Calcaneus

Together, the bones of the foot form a very complex mechanism that compensates for the tremendous stress during the day and helps absorb shock with every step.

Causes of metatarsal fractures

The main causes of fractures of the metatarsal bones of the foot are:

Intense and prolonged sports loads
Osteoporosis (weakening of the bone)
Dropping a heavy object on the foot
road injury
Fall from a height (jump)

Fracture symptoms

Pain that develops gradually increases with exertion
Foot swelling
Subcutaneous hemorrhage (bruising)

Patients with these symptoms typically experience a sudden onset of sharp, intense pain after an injury. Sometimes the patient may hear a crackling or clicking sound at the time of the injury. The pain causes the patient to limp. Patients with metatarsal fractures also have swelling that increases during the day and decreases at night. In severe metatarsal fractures with displacement, obvious deformity may not be noticeable.

Diagnosis of metatarsal fractures

For a more detailed understanding of the problem, the doctor finds out the mechanism of injury in the patient, including the force, place of application and direction of impact.

Stress fractures are usually associated with an increase in the intensity or duration of repetitive movements such as running, ballroom dancing, etc.

Inspection: Careful examination and examination of the entire foot and ankle joint is critical in identifying associated injuries. Deformity, swelling and hemorrhage are visualized without difficulty.

X-rays in 2 projections are usually sufficient to diagnose a fracture. But with non-displaced stress fractures, sometimes they cannot be identified even by a very experienced doctor.

In such cases, control radiographs are prescribed after 10-14 days, when bone tissue resorption occurs at the fracture site. Also, stress fractures are difficult to see on x-rays until they begin to heal and callus begins to form. It is very visible on x-rays. Computed tomography or MRI may be needed to rule out a stress fracture and other foot pathologies.

First aid for metatarsal fractures

Limitation of loads and movements. It is important to limit movement and stress on the foot to prevent further injury.
Cold locally. Using ice will help slow down or reduce swelling and provide a feeling of numbness that will relieve pain. It makes sense to apply ice to the injury site during the first 48 hours after the injury. Never keep ice for more than 20 minutes at a time to prevent frostbite. Rest 1.5 hours before re-exposure to ice, this allows tissues to return to normal temperature and trophism, repeat as needed. You can wrap any frozen product in a towel and apply to the injury site. Ice should be applied as soon as possible after injury. (Don't put ice directly on your skin. Also, don't leave ice on while you sleep for more than 30 minutes. This can cause frostbite.)
Elastic bandage. Wrap your leg with an elastic bandage. But bandage correctly, not too tight. If the fingers become cold, there is numbness, then the bandage is too tight. An elastic bandage will limit swelling and restrict movement in the joint. You can sleep without a bandage. But to move be sure to bandage your leg with an elastic bandage.
exalted position. Elevate the injured leg, for example by resting your leg on a pillow while lying on a couch or bed. If you are sitting, you can put your foot on a chair, this will reduce swelling and pain.

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

It is important to limit the load when walking (not to lean completely on the foot) until the damage is diagnosed by a doctor.

Treatment of fractures of the metatarsal bones of the foot

Conservative treatment of mold bone

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

The goal of any treatment for metatarsal fractures- help the patient return to a full life. Following the recommendations of the doctor will help the fastest recovery of foot function and prevent further problems in the future.

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

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

If the fracture of the metatarsal bone with a slight displacement, an attempt is made to reposition and fixation with a plaster splint.

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

Metatarsal fracture surgery

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

Percutaneous fixation with wires

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 through the fragments in certain (given the nature of the fracture) directions, the needles are drilled.

Pros: low invasiveness, speed, ease, low cost, no incision and, as a result, a postoperative scar.

Minuses: the ends of the pins remain above the skin so that the pin can be removed after the fracture heals; the risk of infection of the wound and the penetration of infection into the fracture area; long-term wearing of a plaster cast for 1 month; inconvenience in everyday life.

Open reposition of the fracture

Open reposition in case of a fracture of the metatarsal bone of the foot, plate osteosynthesis with a plate and screws. The operation includes a surgical incision, access to the broken metatarsal bone, gently retracting tendons, vessels and nerves, mobilization of bone fragments, elimination of displacement and fixation in the correct position.

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

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

Rehabilitation after a metatarsal fracture

As soon as the fracture of the metatarsal bone grows together and the pain decreases, the doctor will allow you to step on the foot in a dosed manner, gradually increasing the load.

Do not self-medicate!

Only a doctor can make a diagnosis and prescribe the right treatment. If you have any questions, you can call orask a question on .

Tubular bones in the human body are most susceptible to injury. Fracture of the fifth metatarsal, despite the fact that it does not seem too dangerous, can bring a lot unpleasant symptoms and complications. And not only professional athletes are subject to such damage, but also ordinary people, since the fracture mechanism is very common - this is a dislocation of the foot. How to cure damage and avoid complications?

Kinds

Fracture of the fifth metatarsal bone can be divided into several types:

Fatigue (stress) develops under the influence of long loads, repeated indefinitely. Most exposed this species injuries recognize athletes who are forced to repeat certain elements. A full break does not occur, only a crack appears. The prognosis is greatly aggravated if there is a deformity or there is osteoporosis.
The marching fault is one of the most dangerous, because it often heals poorly and is accompanied by complications. The therapy itself takes a long time.
A fracture at the base of the fifth metatarsal is commonly referred to as a Jones fracture. In this area, the foot does not have such good circulation, so the formation of calluses is delayed.
Traumatic, respectively, are provoked by a blow, fall, dislocation and other similar situations. Their severity depends on the force that is applied to break.
An avulsion fracture occurs as a result of the contraction of the tendon. This force tears the fragment from the attachment point. It develops at the time of dislocation of the foot. It is easiest to confuse it with a sprain, since visually it looks exactly like this injury.

The most common fracture is the fifth metatarsal. Its fracture is usually accompanied by a displacement, and sometimes a wound. In this case, the symptoms of the injury affect the entire ankle.

It doesn’t matter if a metatarsal fracture has occurred without displacement or with it, it still requires immediate contact with the clinic, since if the fusion is incorrect, the risk of complications is higher.

Symptoms

At the time of injury, several characteristic signs may be present at once:

pain;
crunch, which sometimes persists after the impact;
deviation towards the finger, its shortening;
bruise.

Due to pain, the leg is not able to fully perform its functions, the person suffers from lameness. If the metatarsal bone is damaged with a displacement, there is a noticeable varying degrees deformations.
The fatigue form of damage is more difficult to determine, since in this case the victim detects only edema. Pain is also present, but it subsides after a short rest.

First aid

After detecting signs characteristic of an injury to the 5th metatarsal, the following measures should be taken:

Restriction of any motor activity, which will avoid the divergence of fragments.
Applying cold to the skin area reduces the severity of pain, swelling and bruising will be less. You can hold the compress for only 20 minutes, re-imposition possibly after 2 hours.
Bandaging of the leg. You can also use elastic bandage, but the main thing is that the bandage is not tight. Thus, careless movements and swelling are prevented.
The limb is placed on any object so that it is higher than the body.
The open form of the fracture, although rare, requires careful treatment with antiseptics, immediate bandaging and transport to the hospital in order to prevent infection open injury. At the same time, it is forbidden to touch the fragments.
If the fracture is combined with other injuries, it is not forbidden to give the victim an anesthetic.

Do not massage or treat the area with alcohol, as well as apply warm compresses! Such measures will aggravate the swelling. After being taken to the hospital, the victim should be helped in movement so that he does not overload the foot.

Treatment

A conservative technique after a fracture is to apply a splint of gypsum. It is used only for those types of faults that are not accompanied by displacement. How long does the period of restoration of bone tissue take, is determined by individual features, because not only the nature of the injury plays a role, but also internal diseases.

Diseases associated with metabolic processes, trophic disorders, osteoporosis, diabetes mellitus.

With a stress fracture, the doctor does not always apply a cast, sometimes replacing it with a tight bandage. Small cracks can be treated in this way, but for some time it is better not to disturb the foot. Faults with a slight displacement are also treated conservatively.
How long does it take to be in a cast? The immobilization period is up to 2 weeks in the presence of a crack and up to 6 weeks in case of complicated damage.

Surgery

The connection of broken fragments that have shifted from their normal physical position occurs through metal knitting needles. Only such structures are able to keep them in a normal position, but treatment with plaster immobilization will not bring results.
Interestingly, to perform such an operation, it is not necessary to open the site of injury; manual reposition is sufficient. This is important, since there are no risks of complications characteristic of any intervention. However, there is still a possibility of infection through outer part knitting needles, so a lot of attention is paid to the processing of the puncture site.
An open reduction technique is needed to place plates and screws. It can be used for poor healing of a damaged bone.
After surgical treatment a plaster cast is still required to fully restore the structure of the metatarsal bone.

Effects

The development of complications after a fracture is a risk that haunts any such injury. Some areas of the metatarsal bone (especially the base) are poorly supplied with blood, so the situation can develop from an acute situation into a chronic one. In such cases, the fracture does not heal completely or this process does not go well, which leads to the fact that the victim will experience pain when walking.

If the doctor insists on more long period wearing a cast, it is better to agree with him, otherwise there is a great risk that the foot will not function normally throughout life.

Complications are of other types:

permanent aching pain and inflammation;
deformation;
arthrosis;
rapid fatigue of the foot.

rehabilitation period

When the plaster splint is removed, the active phase ankle development. During this period, the doctor already allows you to load the leg, but still it is better to walk, leaning on a cane or crutch. Walking begins even in a cast - this is an integral part of the successful restoration of the function of the entire foot.
Rehabilitation is supplemented by a number of measures: exercise therapy, hydrotherapy, applications, electrophoresis, massage and other methods. Some of these procedures are carried out even at the stage of wearing a cast, from about 3-4 days from the occurrence of a fracture. Recovery implies a diet rich in microelements and proteins.
For at least a year, arch supports or orthopedic insoles should be worn. In this way, it is possible to distribute the load between all metatarsal bones, otherwise the foot under the pressure of the weight is threatened by flat feet. It is advisable to wear such insoles at all times and try to choose comfortable shoes to prevent re-injury.

Metatarsal injuries cover 40-45% of all cases of foot fractures. There are two large groups such pathology: caused by mechanical influences and resulting from fatigue. A fracture can be obtained both on one metatarsal bone, and simultaneously on several. On this basis, a single or multiple pathology is distinguished. Most often, the 2nd, 3rd and 4th metatarsal bones are subject to fracture, deformities of the first are rare, and cases with damage to the fifth are considered the most difficult. According to the type of injury, there is a division into open or closed forms.

Symptoms of a fifth metatarsal fracture

Signs of pathology vary significantly depending on the type. In some cases, such as with stress fractures, the patient may well mistake the symptoms for simple bruises. Maybe complete absence pain, and pathology is determined only by indirect signs. fatigue march fracture metatarsal bone is expressed by the following symptoms:

the appearance of pain in the foot after exercise;
the formation of edema, but without bruising;
disappearance of pain at rest.

Traumatic fracture is more pronounced. In these cases, when the bones are damaged, a characteristic crunch is clearly audible, which automatically indicates the resulting deformation. After that, pain appears almost immediately. Other signs of a traumatic fracture are:

the appearance after a few hours of severe edema with a hematoma;
unnatural position of one or more fingers;
subsidence of pain with subsequent increase during exercise.

An open fracture of the metatarsal bone of the foot is characterized by a rupture of the soft tissues with bleeding. It provokes a strong pain syndrome which is hard to miss. The ends of the metatarsal bones come to the surface, which are easy to detect visually through torn skin. A fracture of the metatarsal bone of the foot needs to be treated in without fail even if the symptoms are very mild, as it can cause serious complications.

Lit.: Large medical encyclopedia 1956

There are two types of fractures, each of which is caused by its own factors. The fatigue form has more light form currents, often goes away on its own. It is caused by prolonged excessive stress on the foot. They may occur when:

drill training;
long walks;
carrying weights.

In these cases, the foot becomes loaded long time, which leads to the appearance of microcracks in the bone tissue. Traumatic fractures are more clear reasons. Their appearance is associated with external mechanical action directed at the forefoot. Such situations may arise when:

traffic accidents;
falling on the foot of a heavy object;
an unsuccessful landing after a jump.

With a traumatic form of pathology, a fracture of the 5th metatarsal bone most often occurs. The next in terms of the number of deformations are the first and second. Situations are considered especially difficult when a Jones fracture occurs: the fifth bone is destroyed in the area of limited blood supply.

With any damage to the foot, it greatly loses its depreciation properties. This leads to the fact that the load begins to be redistributed to other parts of the musculoskeletal system, which may well lead to new pathologies. Therefore, if the metatarsal bone is fractured, treatment is considered necessary. Diagnosis of the disease and its therapy is engaged in:

At the appointment, the doctor will immediately conduct an external examination of the foot with its palpation. In order to get a clear picture of the damage, he will need answers to the following questions:

How long ago did the fracture occur?
What are the symptoms and with what force manifested in the injury?
The patient has chronic diseases musculoskeletal system?
Features of professional activity?
What measures were taken to relieve pain symptoms?

A fracture of the fifth metatarsal, like other deformities of the foot, requires a mandatory x-ray examination. If necessary, computed tomography is used instead, showing not only the deformation of the bones, but also the condition of the soft tissues and blood vessels. The doctor always takes into account that in stressful forms, X-rays do not always indicate pathology, since it develops inside the bone tissue, and the surface remains intact.

Treatment of a fracture of the 5th metatarsal

Therapy of the disease in this injury can be both conservative and operational. The first one is used for closed fractures no offset. In this case, ointments, gels are used to relieve swelling, special diet and maximum rest of the injured limb. Casting is often unnecessary in such cases. Surgery used when bone fragments are displaced by more than half the diameter or when open forms injury. It consists in:

reposition of fragments;
fixing parts of the bone with special screws or plates;
restoration or resection of blood vessels;
suturing soft tissues.

A fracture of the 5th metatarsal bone of the foot after surgery requires a mandatory plaster cast. The course of treatment is controlled by periodic hardware studies. After the plaster is removed, the therapy goes into the rehabilitation period, the purpose of which is the complete restoration of the functions of the musculoskeletal system. All procedures are carried out under the supervision of a doctor, which excludes complications.