Metatarsal Fracture

A metatarsal fracture is a partial or complete break in one of the metatarsal bones in your foot. The metatarsals lie in the midfoot between the bones of the ankle and toes. When one of these bones is fractured, there may also be damage to surrounding soft tissues and blood vessels.

Causes and Symptoms
Metatarsal fractures can occur from a strong blow to the foot or stress on the midfoot. Commonly, the injury can be linked to a fall, sports injury, or disease.

Patients usually report pain and swelling with the fracture. The foot may feel cold or there may be a loss of sensation below the injury site. More serious breaks may result in deformity in the foot.

Treatment
Immediate Care: Rest the affected foot. Apply an ice pack wrapped in a towel on the area to control swelling. Immobilize the lower leg and elevate the foot. See a doctor as soon as possible.

Medical Care: Your doctor will discuss your symptoms and the history of the injury with you. A physical examination will be completed. X-rays will be needed to identify the location and extent of the break. A tetanus shot may be required if the bone has broken through the skin.

Non-operative treatment includes setting and immobilizing the bone. Hands-on manipulation is used to align the bone. A cast is applied to hold the bone in place.

Operative treatment involves surgical repair to set the bone with hardware, such as pins or screws. Surgery also allows the surrounding soft tissues to be repaired. A cast will cover the area from below the knee to the toes.

Medications
Anesthesia and muscle relaxants may be used when the bone is set or during surgery. Your doctor may also recommend medications to control swelling and decrease pain.

Recovery
Initially, crutches or a walker will be needed to avoid placing weight on the affected foot. You will be able to bear weight again gradually. You will also be instructed in how to move your foot and ankle to prevent joint stiffness.

During the healing phase, heating pads may be applied for comfort and to promote blood flow. After the cast is removed, ice massages are also helpful in controlling pain and swelling (2 to 3 times per day, 10 to 15 minutes at a time).

Long-term recovery usually takes about 6 to 8 weeks. Your outcome depends on your age, overall health before the injury, and how well you follow your doctor's instructions.

Complications
Complications that may occur with metatarsal fractures include:

• Infection
• Poor healing at the fracture site
• Bone shortening or deformity
• Impaired sensation
• Impaired blood circulation
• Loss of range of motion