Metatarsal fracture is a common type of injury. Approximately one-fifth of visits to traumatologists for leg fractures are associated with this diagnosis. It is easy to get such a fracture even while walking on a rough road in uncomfortable shoes, when jumping on a hard surface, due to hitting a curb or wall with your foot.

Fracture of the metatarsal bone of the foot - symptoms

The foot is a highly complex mechanism, consisting of many bones, and five of them are tubular metatarsal bones located between the digital phalanges and the tarsus. These bones serve as a kind of lever that sets the foot in motion when moving, jumping, helping to maintain balance and stability. Even a slight fracture or crack in one of these bones significantly affects the ability to move.

A fracture of the metatarsal bone of the foot is manifested by the following symptoms:

• crunching at the moment of injury;
• sharp pain sensations, which at first can be muffled by shoes that tightly hold the foot, but then always become more pronounced;
• pain is aggravated by movement and touching the foot;
• difficulty moving, lameness;
• increasing swelling of the foot;
• bluish tissue at the site of injury.

Signs of a metatarsal fracture are not always obvious to patients, and such an injury is often mistaken for a severe bruise or sprain. This is especially true in situations where the fracture is not traumatic, associated with a sharp mechanical impact, but stressful. Stress fractures begin as a small crack in the bone as a result of regular stress on the feet, often in athletes. In the clinical picture of such a fracture, aching pains are noted after exertion, subsiding at rest, intensifying over time and accompanied by edema.

Fracture of the metatarsal bone of the foot without displacement

In cases where no shifts of bone fragments are observed during a fracture, the damaged bone retains an anatomically correct position. Such injuries are less dangerous, easier to heal and grow together. Separately, it is worth highlighting a fracture of the fifth metatarsal bone of the foot without displacement, called a Jones fracture. Because in this area of ​​the foot, microcirculation is limited, it is less supplied with nutrients, with this type of damage there is a risk of bone tissue necrosis. Therefore, delay in contacting a doctor can have the most adverse consequences.

Fracture of the metatarsal bone of the foot with displacement

It is possible to recognize a fracture of the metatarsal bone, accompanied by separation and displacement of bone fragments, by a visual change in the structure of the foot, but this is not always noticeable. An accurate picture of the injury can only be obtained through x-ray diagnostics. A fracture of the metatarsal bone of the foot with displacement is dangerous for the development of bleeding and an increase in the risk of suppurative processes in the tissues. If you do not see a doctor in time, the fusion may not occur correctly, and a complex operation will be required.

Fracture of the metatarsal bones of the foot - treatment

How long a fracture of the metatarsal bone of the foot heals, whether there will be complications of the injury, is largely determined by the timeliness and correctness of medical care. Immediately after an injury, the following actions should be taken:

• fixing the foot in one position by applying a splint;
• with an open injury - the imposition of a sterile bandage;
• applying a cold compress (for about 15 minutes);
• ensuring rest of the lower limb in an elevated position.

Treatment depends on the severity of the fracture and the location of the injury. With the help of a two-projection x-ray, it is possible to determine what kind of fracture is present - the base of the metatarsal bone of the foot, diaphysis, neck or head, what is the fault line, is there a displacement of the fragments. Main treatment options:

• immobilization of the foot with a plaster bandage - in cases of a fracture without displacement;
• closed reposition - comparison of bone fragments with their slight displacement without incision of the skin;
• osteosynthesis - surgical restoration of the anatomical placement of bone fragments with their fixation with special parts (plates, pins, screws) and subsequent plastering, performed with a strong displacement and multiple injuries.

To save the foot from the load, when moving, you will need to use crutches until the fracture is completely healed. In the supine and sitting position, the limb should be raised. The patient must be observed by a doctor during the period of wearing a plaster cast, for the timely detection of possible complications. Calcium and vitamin D supplementation is recommended to improve bone fusion.

Fracture of the metatarsal bone of the foot - plaster boot

If a fracture of the metatarsal bone of the foot is diagnosed, it is superimposed in most cases. Often, gypsum is performed like a boot from the upper third of the lower leg to the ends of the fingers. Such fixation is necessary to ensure the immobility of bone fragments and their correct location, to protect against various external mechanical influences. The period of wearing a cast in case of a fracture of the metatarsal bone of the foot is 1-1.5 months.

Foot orthosis for metatarsal fractures

In mild cases without displacement, it is allowed to use a foot fixator for a fracture of the metatarsal bone - an orthosis. This device, made of polymeric materials, is designed to stabilize, fix and unload the foot. From an aesthetic point of view, an orthosis is more acceptable, but gypsum is more reliable. If more than one bone fracture has occurred, there are displacements, then this option of immobilization is unacceptable.

Treatment of a fracture of the metatarsal bone of the foot with folk remedies

If a foot fracture is obtained, the treatment prescribed by the doctor can be supplemented with folk recipes. Local procedures during the period of wearing a plaster cast are not carried out, but to accelerate the fusion of bone tissue, reduce pain and relieve inflammation, it is recommended to use therapeutic agents inside. Here is one of the recipes.

How long does a metatarsal fracture take to heal?

On average, an open and closed fracture of the metatarsal bone of the foot heals within 6-8 weeks. How long a metatarsal fracture heals depends on several factors that determine the individual regenerative abilities of the body:

• level in the body
• the presence of chronic pathologies that prevent tissue fusion;
• patient's age;
• compliance with medical prescriptions.

Rehabilitation after a fracture of the metatarsal bones of the foot

After removing the plaster cast, when the fusion of the bones is confirmed by X-ray, a rehabilitation period follows. Recovery from a metatarsal fracture takes about three to five weeks or more. During this period, it is required to develop the muscles and tendons of the foot, normalize the mobility of the joints, and prepare them for stress. At first, when walking, you should rely only on the heel, gradually placing the entire foot on the floor. It may be recommended to bandage the foot with an elastic bandage, wearing orthopedic shoes with hard soles or arch support insoles.

The complex of rehabilitation measures includes:

• recreational gymnastics;
• massage;
• physiotherapy;
• complete nutrition.

How to develop a foot after a metatarsal fracture?

In order to speed up recovery time, special exercises are recommended after a fracture of the metatarsal bone of the foot. Here is a set of basic exercises, each of which should be performed 10-15 times:

1. Extension and flexion of the toes.
2. Stop turns left and right.
3. Stretching the feet away from you and towards you.
4. Transferring body weight to the toes and back (in the early days, this exercise should be done while sitting, then with support on the back of a chair, and then in a standing position).
5. Circular rotations of the feet clockwise and counterclockwise.
6. Rolling a dense roller with your feet back and forth.
7. Cross leg swings in the prone position.

Foot massage after metatarsal fracture

The development of the foot after a fracture of the metatarsal bone through massage is aimed at activating blood circulation and lymphatic drainage, improving the nutrition of damaged tissues. If it is not possible to go to procedures in a medical facility, a gentle massage can be performed independently, using circular, longitudinal and transverse strokes with the tips and knuckles. You need to knead the inside and outside of the foot, toes.

The consequences of a fracture of the metatarsal bone of the foot

A fracture of the fifth metatarsal bone can occur as a result of heavy objects falling on the foot, strong blows, after an incorrect jump from a height, jogging, sports, at work. At the moment of injury, a crunch is heard, the patient cannot step on his foot. Fracture of the fifth metatarsal heals 6-8 weeks, and sometimes longer.

Healing time for different types of fracture

The length of the recovery period depends on the type of fracture. The more severe the injury, the longer it takes to recover.

Fracture of the 5th metatarsal bone is:

• with offset;
• no offset;
• transverse, oblique, t-shaped, wedge-shaped;
• at the base, body, head;
• open, closed.

Fracture of the base of the 5th metatarsal bone of the foot is very common. The bone breaks in closer to the ankle, next to the articular head. This type of fracture can be closed or open. In the first case, the recovery time lasts more than 12 weeks, requires surgical assistance to match the debris and restore the integrity of the soft tissues.

A closed fracture without displacement requires minimal time for rehabilitation. A patient after an injury requires mandatory immobilization (immobilization of the foot) until the bone is completely healed (approximately 4 weeks). The recovery time also depends on the age of the patient and the strength of his bones. In patients with osteoporosis (calcium deficiency), the bone heals longer.

A displaced fracture requires additional measures to match the edges of bone fragments and prompt assistance when soft tissues (ligaments, tendons, muscles) are damaged. The duration of the immobilization period during displacement is 2 months.

Sometimes the fifth metatarsal can break into several pieces. During surgery, it is made up in pieces, fastening them together with special metal plates. Immobilization with such an injury will last more than 2 months.

After any fracture, a plaster bandage in the form of a boot is shown. It fixes the leg well and does not allow the debris to move. With cracks in the bone, an orthosis is used - a special fixator of the foot.

The healing time of the fracture also depends on the accuracy of following the recommendations of the orthopedist or surgeon. You can not step on the foot with all your weight, even in a plaster cast, as a second displacement of the debris may occur. It is allowed to step on the heel, but very rarely. It is advisable not to move your fingers when applying a tight bandage. The patient should move only on crutches.

The gypsum is removed when the bone is completely healed, which can be seen on an x-ray. X-rays are done in 2-3 projections (oblique, lateral, direct) in order to fully verify the recovery of the patient.

Trauma Recovery

Rehabilitation after removing the plaster takes another 1.5-2 months, depending on the patient's condition. A buried fracture without displacement (one crack) heals faster than other types of injuries. After removing the plaster cast, the patient must begin therapeutic exercises, try to walk, gently stepping on the foot. You need to move with crutches to reduce the load on the metatarsal bone. At first, it is better to step on the heel, gradually transferring the weight to the full foot. Walking is desirable to carry out in the fresh air, daily increasing the distance traveled.

The patient is shown a professional massage. If the patient cannot attend the procedure in the clinic, then he is taught the technique of self-massage (longitudinal stroking of the foot, circular movements on the back and plantar surface).

Physiotherapy exercises include a list of exercises to restore muscles and ligaments that have not worked for a long time. They must begin from the day the immobilization ends.

List of exercises:

• flexion and extensor movements of the toes;
• transitions from heel to toe in a sitting position;
• pulling the foot towards you;
• stretching the foot away from you;
• foot turns left and right (alternately in each direction);
• rolling a ball, roller or stick along the sole;
• crossing the legs in a prone position;
• foot circular motion.

Nutrition, drugs and medical and social expertise

To speed up recovery after a fracture, the patient needs to eat right. The diet should contain a complex of vitamins, calcium. Recommended dairy products:

• cottage cheese;
• milk;
• yogurt;
• kefir;
• cottage cheese casserole.

Fried, smoked, spicy dishes should be excluded from the diet. You need to eat more fruits, vegetables, pure fish and dishes prepared with it (casserole, fish soup, steamed fish cutlets) are also useful.

For rapid healing of the fracture, doctors prescribe vitamin complexes (Complivit, Alphabet), calcium preparations (Calcium-D3-Nycomed, Calcemin, Complivit-Calcium). Chondroprotectors (Teraflex) contribute to bone regeneration, especially if the fracture is located near the joint.

Painkillers and ointments help to reduce the intensity of pain. External agents are used if the integrity of the skin is not violated.

To reduce the risk of complications and flat feet, the patient should wear orthopedic insoles and shoes for a year after the injury. Crutches are required during rehabilitation.

Employability and disability

In case of a fracture of the 5th metatarsal bone of the foot, a working patient is issued a disability certificate for the entire period of treatment and rehabilitation. It lasts from 1.5 to 3 months, sometimes longer, depending on the type of injury. In a complicated course of the disease with a violation of the support function, which significantly reduces the ability to work, the patient can be assigned a 3rd disability group. Its terms are determined by the clinical expert commission, depending on the type of disease (1-2 years or more). If the patient has a disability, then he is entitled to a cash allowance (the amount is set by the state), discounts on medications, crutches, orthopedic shoes and insoles. Patients receive a 50% discount on spa treatment.

Fracture of the fifth metatarsal of the foot

During walking, the bones of the foot take on huge loads, absorb shocks. The metatarsal bones are exposed to serious physical stress on a daily basis. Since all elements of the foot are closely interconnected, a fracture of the metatarsal bone of the foot leads to a violation of the functionality and deformation of other bones. Most often, the base of the 4th and 5th metatarsal bones is damaged, the third - much less often.

Most often, the following factors lead to damage:

• Osteoporosis is a weakening of the bones, insufficient calcium content in them.
• Injury from a fall from a height, an accident, a sharp lowering of a heavy object on the foot.

The risk group includes men and women, aged 20 to 40 years, leading an active lifestyle, athletes.

A fracture of the foot is quite dangerous for its consequences, therefore, at the slightest suspicion of damage to this part of the body, a visit to a doctor should be immediate.

Characteristic signs of injury

The main symptoms that make it possible to suspect damage to the metatarsal bone of the foot are as follows:

• Cracking when the foot is injured.
• Pain that occurs immediately or after a short time, aggravated by trying to step on the foot.
• Insufficient mobility of the foot.
• Decrease in temperature and numbness of the leg.
• The foot takes on an unusual appearance.
• A noticeable shortening of the fingers, there are tubercles under the skin, formed by displaced fragments, deviation of the metatarsal bone to the side.
• Edema, which usually appears on the second day after the injury.
• Bleeding - with an open fracture of the bones of the metatarsus.

Sometimes the symptoms can be “erased”, only a specialist can accurately determine whether there is damage using special examination methods.

Fracture classification

There are several types of metatarsal fractures, all of which have their own characteristics.

Traumatic fracture

It happens when the leg is twisted while walking, or when a heavy object falls on the foot.
Traumatic fractures are of several types:

• open and closed;
• comminuted metatarsal fractures with and without displacement.

If the fracture is not displaced, then the metatarsal bone is located in the anatomically correct place. An open fracture of the 4th metatarsal of the foot, the fifth, third, second or first, is accompanied by a violation of the skin, bleeding, the presence of bone fragments that are visible from the wound. Such injuries are dangerous by the risk of infection, the development of tetanus, sepsis, gangrene, osteomyelitis.

Jones fracture

Is the most serious. Occurs in the fifth metatarsal bone of the foot, where the blood supply is limited. Since a sufficient supply of oxygen and nutrients is necessary for high-quality bone healing, with poor blood supply, healing slows down, which leads to necrosis of bone tissues. In some cases, the Jones fracture does not grow together, the person becomes disabled.

fatigue fracture

It happens due to increased stress on the foot. At risk are athletes, the elderly, who, due to age-related changes in the body, have reduced bone density, have a history of osteoporosis, arthritis. In addition, it can occur when wearing narrow and uncomfortable shoes, with a pathological shape of the bones.

The symptoms of a metatarsal stress fracture are as follows:

• slight swelling of the tissues;
• a person can accurately indicate the location of the onset of pain;
• soreness of the damaged area, which occurs during physical exertion, and disappears after rest;
• Gradually, pain becomes a constant companion of a person.

On x-ray, such an injury is represented by cracks.

Avulsion fracture

A similar injury to the metatarsal bone occurs when the foot is tucked inward. It is combined with a sprain, a fracture of the ankle joint, which makes it difficult to diagnose. When damaged, a detachment of the bone fragment occurs under the influence of the tension force of the tendons.

A fracture of the fifth metatarsal is similar to a sprain, because a person is in no hurry for medical help, which leads to a slowdown in the recovery of motor activity.

Possible Complications

If you do not seek medical help in a timely manner, an injury can lead to various consequences:

• Bone deformities that restrict movement make it difficult to fit shoes.
• With an intra-articular fracture of the fifth metatarsal bone, arthrosis in the area of ​​damage may develop over time.
• If the fracture is splintered, and the bones were not repositioned into place, then during fusion, an angular deformity of the foot develops.
• Chronic pain in the foot.
• Rapid fatigue of the legs.

Diagnostic methods

X-ray of the foot with a fracture of the 5th metatarsus

First of all, in case of a fracture of the metatarsal bone of the foot, a specialist conducts a visual examination of the leg, it turns out the mechanism of injury. Symptoms such as hemorrhage, swelling and deformity of the foot appear almost immediately with a fracture of the metatarsal bone in children and adults.

Next, an x-ray is performed in two projections, which is enough for the doctor to determine a fracture with displacement, but if a stress fracture of the metatarsal bones of the foot has occurred without displacement, then even a specialist with extensive experience will not be able to accurately diagnose. X-ray is repeated after 2 weeks, when the callus begins to form, which is visible in the pictures.

If it is difficult to determine a fracture of the 5th metatarsal bone, as well as the fourth or third, second or first, MRI or CT is prescribed.

First aid

The following manipulations can reduce the suffering of a person with a metatarsal injury to the provision of qualified assistance:

• Complete limitation of the load on the leg, which will prevent the deterioration of the situation.
• A cold compress is applied to the area of ​​a closed fracture of 1, 2, 3, 4 or 5 bones of the foot, which reduces swelling and relieves pain. The duration of the procedure is 20 minutes, the interval between exposure to cold is 1.5 hours.
• An elastic bandage is used to fix the foot, but should not be tightly bandaged. If the toes become cold, with a bluish tint, the foot numbness is felt, then the bandage should be loosened in order to resume the normal blood supply to this part of the body.
• After a metatarsal fracture, the leg should be in a horizontal position at some elevation. You can put a tight pillow or sofa cushion under the limb.

In the first week, it is forbidden to heat, rub with alcohol, massage the damaged area, as swelling may worsen.

Depending on the location, complexity of the injury, the tactics of treatment are determined. If the patient follows all the recommendations of a specialist, the damage will heal quickly.

Conservative therapy

If the fracture is open, or there is a significant displacement of the fragments of the metatarsal bone, then an operation is performed. Uncomplicated injuries are treated by the following methods:

• In case of a fracture of the base of the fifth, fourth, third, second or first metatarsal bones without displacement, gypsum is not applied. But, if a child is injured, then it is impossible to do without a cast, since it is difficult for a child to explain why one should not step on the foot.
• With traumatic fractures, it is allowed to walk, stepping on the heel or using crutches.
• In case of fatigue fractures of the metatarsal bone, the recovery process takes place under mandatory loads, but with the use of orthopedic insoles, due to which stress is removed from the damaged area.
• When displaced, the patient will have to walk in a cast.

Surgery

Depending on the complexity of the injury, several types of surgical intervention are offered.

Fixation with needles through the skin

The most popular treatment method. First, the surgeon in a closed mode (without an incision) correctly positions the fragments, then, taking into account the nature of the fracture of the metatarsal bone, they are drilled and fixed with pins.

Negative sides:

• the needles remain visible above the surface of the skin, which allows them to be removed after a while;
• there is a risk of infection entering the wound;
• the bandage needs to be worn for one month, which causes inconvenience.

The positive aspects of this procedure are: low cost, fast and low trauma, no postoperative scar.

open intervention

During the operation, a surgical incision is made to gain access to the damaged area of ​​the metatarsal bone. Tendons, nerves and vessels are retracted, fragments are collected, displacement is eliminated. With the help of a plate and screws, the bones are fixed in the correct position. After the operation, the doctor allows the patient to walk, but for 1 month. you can only step on the heel.

rehabilitation period

Every patient who has suffered a fracture of the base of the 5th metatarsal is concerned about the question: "Is it possible to step on the foot immediately after the removal of the cast and how long will the recovery period take?" Patients need to listen to the doctor's advice, which is purely individual.

• If the patient wears a plaster cast for more than 5 weeks (Jones fracture), then one should not hurry with independent walking, and continue to use crutches for two or more weeks.
• If the cast was worn for a short time, then immediately after removal, you can begin to develop the leg.
• Exercise therapy and therapeutic exercises have a positive effect on the speed of recovery.
• Warm foot baths with sea salt or medicinal herbs are prescribed, which will strengthen the bones and have a calming effect.
• Massage is carried out by specialists.
• Walking - you should not walk a lot during the rehabilitation period, but it is useful to overcome short distances 3-4 times a day, gradually the distance should be increased.

In the normal course of the disease, damage to the metatarsal bone of the foot heals in a short time - only 3-4 weeks. Recovery takes from 10 days, which depends on compliance with the recommendations of the doctor and the severity of the fracture.

A metatarsal fracture is considered a common injury. It is more often diagnosed in those who lead a fairly active lifestyle. The whole reason is that this bone of the foot bears the maximum load. It will not work to determine the fracture on its own, since medical assistance and X-ray diagnostics are necessary. In order to avoid complications in the future, appropriate treatment and proper first aid are necessary.

It is possible to diagnose a fracture of the metatarsal bone of the foot both in adults and in overly active children. At risk are people aged 20 to 45 years. Also, such an injury often occurs in athletes. Reasons for a fracture:

• Osteoporosis of bones (weakening of tissues due to lack of calcium);
• Incorrect landing during the jump;
• The fall;
• Impact with a heavy object on the foot;
• Uncomfortable and tight shoes;
• Diseases of bone tissue.

To get a fracture, it is enough to stand on the leg incorrectly. Especially this process accompanies.

Characteristic signs of injury

Metatarsal fracture is always accompanied by pain during movement. The tissues at the site of damage begin to redden and swell. With a very strong impact on the outside of the foot, a volumetric swelling is formed, which is visible to the naked eye.

When a fracture occurs, the victim hears a characteristic crunch. After that, a person cannot stand on his leg, because any load causes acute pain. The gait also changes, lameness appears.

With a fracture of the metatarsus, the edema is more pronounced in the daytime, at night it subsides a little, because there is no load on the limb.

Some people pay attention to the local body temperature, it can rise at the site of damage.

If you look at the foot, then with a fracture, the fingers will be slightly shortened, tubercles appear under the skin, the foot takes an irregular shape. Tuberculate formations appear if the bone is severely crushed into fragments. In such a situation, the affected area becomes numb, the person stops feeling the lower part of the limb.

Fracture classification

A fracture of the 5th metatarsal is considered one of the most problematic. It grows for a long time. When traumatization often occurs, the opening of the bone and its further displacement. Metatarsal fracture classification:

• At the base of the bone;
• With offset and without;
• uneven or splintered;
• Open or closed.

At risk are people associated with sports: ballerinas, gymnasts, dancers, football players. The most dangerous are open and comminuted fractures. In such cases, you should not hesitate to visit a doctor. With an open form of injury, there is a possibility of large blood loss.

Possible Complications

Can I walk with a metatarsal fracture? When a bone crack or fracture occurs due to a prolonged load on the foot, the victims continue to move for some time. Often patients do not even realize that a serious injury to the bone tissue has occurred. If there is no severe pain, then the person is convinced that he had a bruise or dislocation. It is this misconception that leads to a number of complications:

• Gradual deformation of tissues, which affects the activity of the limb;
• Development in the area of ​​damage;
• The appearance of angular deformity of the foot due to the presence of fragments and the lack of proper reduction of the bones;
• Constant pain in the joint.

All this leads to the fact that the victim, even after the fusion of the damaged areas, will feel rapid fatigue of the foot. Due to the deformation, the process of choosing shoes is difficult, and this affects not only the foot, but also the spinal column.

Diagnostic methods

When the victim comes to the doctor, he first of all proceeds to examine the limb. It is important for a traumatologist or orthopedist to understand the process of damage itself, that is, because of what the grass occurred.

If there are traces of hemorrhage on the skin, severe swelling and deformation, then these are the three main signals about the presence of a fracture.

The next step in the diagnosis is an x-ray. It is important to take a picture in two projections. A fracture of the 5th metatarsal bone with a displacement is determined only by 2 images. If the injury occurred due to prolonged load, then it will be quite difficult to diagnose a fracture. If the case is complex, then it is appropriate to conduct an MRI or CT scan.

First aid

With a fracture, the victim always suffers from severe pain when pressing on the foot. The main task is to immobilize and not load the limb. If this is not done, then the condition may worsen due to further fragmentation of bone tissue.

• Immobilize the limb and slightly raise;
• Apply a cold compress to the affected area for a maximum of 20 minutes. If medical assistance is not provided for this, then it is worth taking a break for 1.5 hours. The tissues must recover from the cold.
• Next, you need to start fixing the foot with an elastic bandage. This is done so that there is less movement of the limb. With the help of a tight bandage, it is possible to cope with severe swelling, but it is important to monitor the tension. If the bandage squeezes the leg too tightly, then the fingers will become bluish, the limb becomes numb. In this case, the bandage is allowed for a while to restore the blood circulation process.
• If the pain is very severe, then the victim is given painkillers from the category:,.

It is forbidden to massage, pull, rub the affected part of the leg with alcohol. Such actions will only aggravate the condition of the victim. With severe pain, you should call an ambulance.

Conservative therapy

When a fracture of the 5th metatarsal bone without displacement is diagnosed, then more often they resort to a local method of treatment. If the injury occurred at the base without displacement, then gypsum is rarely used. It is worth carrying out mandatory fixation in cases of damage to the child's foot, because he will not strictly follow the doctor's recommendations and not step on the limb.

How long is the activity of the leg lost if a fracture of the 5th metatarsal is diagnosed? How long to wear a cast? Only the attending physician will give answers to these questions, since each case is individual. On average, it takes 6 to 8 weeks for the bone to heal.

Orthopedic insoles will help relieve tension in this area. If a displacement is detected with this type of fracture, then gypsum cannot be dispensed with.

When a fracture of the 5th metatarsal bone does not heal, then it is worth reconsidering the quality of nutrition. There are times when, due to a lack of calcium, the process of tissue repair slows down.

Surgery

The surgical method of treatment is resorted to in cases of complex fractures with displacements and fragments. More often, fixation methods are used with the help of knitting needles through the skin or by open intervention.

The first method is considered common because it helps to correctly position the fragments without a cut. The doctor drills through the bone tissue and fixes the metatarsal bone with pins. This technique should be carried out by an experienced surgeon, because it has several disadvantages:

• High probability of infection in the wound;
• The spokes are removed only after a certain period of time;
• The bandage is not removed for at least 4 weeks.

If you look at this method from the other side, it is characterized by low cost, no scar remains on the skin, the operation does not take long and it is less traumatic.

With open surgery, a tissue incision is made, because the doctor needs to get access directly to the metatarsal bone. With the help of screws and a plate, the surgeon folds the bone in the correct position.

How long does it take for a 5th metatarsal fracture to heal? If surgery was performed, then the patient can walk, but only step on the heel for 4-5 weeks. In other cases, it will take at least 2-3 months, it all depends on the complexity of the fracture.

rehabilitation period

Rehabilitation after a fracture of the 5th metatarsal is a long process, so the patient should be patient. After removing the cast, it is possible to return the limb to full working capacity only after 5-6 weeks.

During this recovery period, the doctor gives the following recommendations:

• Do not rush to walk independently without crutches, especially when wearing a cast for more than 5 weeks;
• In the case of short-term use of the cast, development of the limb should begin as early as possible;
• We must not forget about exercise therapy and special gymnastics. They will help to develop muscle tissue faster, improve blood circulation.
• To relieve soreness after training and soothe the tissues, warm baths with sea salt and herbs are prescribed.
• During the recovery period, you can not abuse it with long walking for long distances. At first, it is enough to load the leg 3-4 times a day. The time of such a load will be indicated by the attending physician.
• Massage will help to develop the foot faster, but it is better to entrust it to a qualified chiropractor.

Fractures of the body and head of the 5th metatarsal are of little note, since their diagnosis and treatment are subject to the same signs as fractures of other small metatarsals. Of particular interest is a fracture of the base of the 5th metatarsal, as it has a number of fundamental differences. Fracture of the base of the 5th metatarsal is a common injury. Depending on the mechanism of damage, there are 3 main zones of fracture localization. With forced inversion of the foot, a fracture occurs in the first zone, with forced adduction of the foot in the second zone, with constantly repeated overload in the third zone. Also, a fracture of the base of the 5th metatarsal is often associated with injuries in the Lisfranc joint, ruptures of the lateral ligament complex.

Anatomy of the 5th metatarsal.

There are 5 main anatomical regions of the fifth metatarsal bone: tuberosity, base, diaphysis, neck, head. The tendons of the short and long peroneal muscles are attached to the base, the third peroneal muscle is attached to the proximal part of the diaphysis.

The blood supply is carried out by the diaphyseal and metaphyseal branches, the second zone is the area of ​​the watershed of these branches, for this reason, fractures in the second zone are prone to nonunion.

Classification of fractures of the base of the 5th metatarsal.

Symptoms of a fracture of the base of the 5th metatarsal.

Pain along the outer edge of the foot, aggravated by the load of body weight. On palpation, pain, crepitus, and abnormal mobility are standard, although the last two symptoms may be absent with an incomplete or non-displaced fracture. Pain worsens with eversion of the foot. For instrumental diagnostics, roentgenography is used in direct, lateral and oblique projections, in rare cases, CT and MRI.

Treatment of fractures of the base of the 5th metatarsal.

Treatment of fractures of the 1st zone is most often conservative. A cast is applied or a rigid orthosis is used, which allows walking with full load immediately after the injury. Immobilization for 3 weeks, after which it is recommended to wear special shoes with hard soles. Some soreness on exertion persists for up to 6 months.

For fractures in the second and third zones without displacement of fragments, a longer immobilization is required: 6-8 weeks. In this case, the load on the leg should be completely excluded (walking on crutches). After the appearance of radiological signs of adhesion, a transition to shoes with a hard sole is possible.

Given the high risk of nonunion in fractures in zones 2 and 3, surgical treatment is recommended. This is due to the fact that in 25% of cases of acute fractures and in 50% of cases of chronic fractures (with a pronounced periosteal reaction and sclerosis of the intraosseous canal) in zones 2 and 3, when treated with plaster immobilization, no union occurs. In the surgical treatment of fractures in zones 2 and 3, intraosseous osteosynthesis with a compression screw is most often used. It is advisable to use large diameter screws (6-6.5 mm) to create adequate compression and eliminate rotational instability. Two different techniques are used: in one, the screw is inserted strictly along the intramedullary canal; before that, it is necessary to carefully drill the canal and pass it with a sword so that the diaphysis does not break when the screw is inserted. In this case, screws of great length cannot be used, since a fracture of the wall of the diaphyseal canal in the narrower cervical part of the bone is possible. The second technique involves the insertion of a screw perpendicular to the plane of the fracture, exiting through the anteromedial cortical plate of the diaphysis. In this case, it is also necessary to drill the channel and pass it with a sword.

In some cases, there is a need for external osteosynthesis using osteoplastic material. Spongy substance from the iliac crest, proximal tibial condyle or bone-inductive material based on tricalcium phosphate can be used as osteoplastic material. For osteosynthesis in these cases, both intraosseous fixation with a compression screw and plate fixation can be used.

If you are a patient and think that you or your loved ones may have a fracture of the base of the 5th metatarsal and you want to receive highly qualified medical care, you can contact the staff of the Foot and Ankle Surgery Center.

If you are a doctor and you have doubts that you can independently solve a particular medical problem associated with a fracture of the base of the 5th metatarsal bone, you can refer your patient for a consultation with the staff of the Foot and Ankle Surgery Center.