Metatarsal Stress Fracture
A Metatarsal Stress Fracture is the second most common location for a stress fracture after the tibia bone.
What Are The Metatarsals?
The metatarsus or metatarsal bones are a group of five long bones in the forefoot, located between the tarsal bones of the hind and mid-foot and the phalanges of the toes. There are five in each foot, one leading up to each toe and forming the metatarso-phalangeal (MTP) joints with the phalanges (toe bones) at the base of each toe. They also form the tarsal-metatarsal (TMT) joints with the tarsal bones towards the ankle.
These five bones are lacking individual names and so they are usually numbered from the side of big toe; the first, second, third, fourth, and fifth metatarsal.
2 Types of Metatarsal Fractures
Metatarsal fractures can be either an acute fracture (through severe sudden impact) or a stress fracture (a more gradual onset, where repetitive stress causes a stress fracture).
Metatarsal Stress Fracture
As mentioned above, a metatarsal stress fracture can develop overtime due to an increase in the intensity of a specific activity too rapidly and in people who suddenly undertake a burst of exercise whose bones are not used to.
Metatarsal stress fractures is common in athletes and army recruits and the main symptom will be foot pain that will gradually increase with time. The pain will be located toward the mid, front of the foot and it will be aggravated by weight bearing activities such as walking or running which will apply continuous stress on the fracture.
The most important form of treatment for a Metatarsal stress fracture is rest and avoiding any weight bearing activities and if that is no possible than the use of a walking boot might come in handy. Rest period is usually between 4 to 6 weeks and returning to activity should be done gradually.
Acute Metatarsal Fractures
An acute metatarsal fracture is a fracture to the metatarsal bones that is caused by some kind of violent impact. Often something is dropped on the foot or the foot might be stamped on.
Alternatively, a violent twisting or turning motion at the ankle may cause a fracture in the 5th metatarsal in particular. These can include an avulsion fracture, where the tendon of the Peroneus Brevis muscle pulls a piece of the bone away. Or a Jones fracture which occurs at the base of the 5th metatarsal. This area typically has a poor blood supply and so healing may be affected and take longer.
The main symptom is an acute pain at the point of the trauma and this can’t be missed. As opposed to a metatarsal stress fracture which develops over time, an acute fracture occurs on the point and time of impact. It will also demonstrate rapid swelling and bruising will appear within 24 hours. Bearing weight will not be possible and there might even be some deformity in the foot.
Treatment for an acute metatarsal fracture will usually include a short cast or boot in the first 2-3 weeks and the foot should be x-rayed after 6 weeks in order to ensure proper healing. For more complex fracture a surgical procedure might be needed. It is important to know that once the cast or boot are removed, a thorough rehabilitation program should begin to regain full mobility and strength in the foot and as with a metatarsal stress fracture a gradual return to any kind of sporting or athletic activity.