Metatarsal Fracture in Depth

Metatarsal Fracture Explained

Metatarsal fractures are the most common traumatic foot injuries. Broken Metatarsals have been prominent across all professional sports in the past five years, with several high profile athletes suffering Metatarsal fractures. Professional soccer players David Beckham, Steve Gerrard, and a few other noteable ones have all sustained this foot injury in recent years. 

To help everyone understand the Metatarsal fractures further, it is probably best to start by explaining the anatomy of the foot. There are five Metatarsal bones in each foot. They are the relatively long bones which are located between the 'Tarsal' bones of the hind foot and the 'Phalanges' bones in the toes. Functionally, the ankle and foot have two principle functions: propulsion and support. The Metatarsal bones play a major role in these functions. For propulsion they act like a rigid lever and for support they act like a flexible structure that aids balance, thus holding up the entire body.

Fractures to the Metatarsal bones can be caused by direct trauma, excessive rotational forces or overuse. During football, direct trauma is usually caused by a player accidently kicking the sole of an opponent's boot, or by an opponent stepping on a player's foot. As there is very little soft tissue to protect the top of the foot, bone injuries are common. The second, third and fourth Metatarsals are the most commonly fractured with this type of injury, although the fifth Metatarsal is fractured more often in soccer.

The fifth Metatarsal is divided into four anatomic segments (the base, the junction of the base and the shaft, the shaft, and the neck) and different types of fracture can occur at each segment.

Fractures of the base of the fifth Metatarsal are the most common fifth metatarsal injuries, and occur as a result of a twisting injury of the foot or ankle. The ankle rolls inward and there is a strong ligament that attaches to the base of the Metatarsal which pulls off a small bone fragment. This type of fracture is invariably treated without surgery, and immediate walking in a removable plastic cast is ideal.

The junction between the base of the Metatarsal and the shaft is the area which creates most problems when fractured. The reason for the difficulty is that bone healing relies upon a good circulation, and this particular area of the bone has a notoriously poor blood supply. Fractures of the shaft of the Metatarsal occur commonly as a result of twisting of the foot when landing from a jump, for example in ballet dancers, and these heal very rapidly with immobilisation, without any need for surgery.

Overuse can cause stress fractures of the Metatarsals. These fractures are common in army recruits as well as sporting individuals are commonly known as 'march' fractures. The patient will normally report about two weeks of gradually increasing pain in the region before an incident 'converts' the stress fracture to a full fracture. The second Metatarsal is the most commonly affected, but the fifth Metatarsal can also be affected. While the stress fracture of the second Metatarsal usually heels well, the healing of a stress fracture to the fifth Metatarsal can be more worrysome.

Metatarsal Fracture Signs & Symptoms

There is severe foot pain with a Metatarsal fracture and the patient will usually find it difficult to walk. Often there will be pain if the fracture site is touched. A swollen foot is fairly common and bruising is usually evident after a day or two.

Metatarsal Fracture Treatment

If a Metatarsal fracture is suspected the patient should be transferred to an emergency department where a doctor can confirm the diagnosis by ordering an x-ray. Immediately following a Metatarsal fracture ice therapy can be effective to help with pain relief, although medication prescribed by a doctor is usually necessary. Ice Packs for a period of twenty minutes every couple of hours may help with the pain.

The ultimate treatment of Metatarsal fractures varies depending on the type of location of the fracture. If the fracture is due to direct trauma and the fracture ligaments are well aligned then the treatment is immobilisation in a Removable Plastic Cast and non-weight bearing for 6-8 weeks. One good way of helping your healing process is to try our Pedifix Forefoot Compression Sleeve (pictured on the left). The Forefoot Compression Sleeve gently controls forefoot edema. This is great for metatarsal stress fracture and following bunion surgery.

The removable plastic cast is better than a plaster cast, because the boot can be removed for physiotherapy treatment, which is aimed at preventing stiffness in the ankle joint. In addition, cardiovascular fitness can be maintained by performing non-weight bearing exercises in a swimming pool uising a Buoyancy Belt.

A removable plastic cast is also usually adequate for 'march'' (stress) fractures of the second Metatarsal and rotational fractures of the fifth Metatarsal. However, stress fractures of the base of the fifth Metatarsal sometimes show a poor healing capacity. For this reason, many orthopaedic consultants now favour surgical fixation. A small incision is made on the outside border of the foot and a small crew is placed down the middle of the fractured bone. With this method a return to sporting activity is usually possible after 6 - 8 weeks. You can also visit our online store, and check out any product that might suit your needs regarding any fracture or broken bones (click highlighted link to visit store).

Metatarsal Fracture Prevention 

If the force applied to the foot during a traumatic incident is high then there is very little that can be done to prevent a Metatarsal fracture. However, it is always important to wear appropriate footwear that gives the foot some protection. Also, for more protection regarding your foot, try out Metatarsal pads (viewable on the left). They can be had here at the office, or by visiting our online store (please click the highlighted link to view the Metatarsal pads).

Recommended Products for Metatarsal Fracture Injury:

Removable Plastic Casts

Faster Bone Healing

Insoles and Orthotics

Ice Packs & Cold Therapy

Rehabilitation Kit