METATARSAL FRACTURE
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Metatarsal Fracture
The metatarsals are the five long thin bones that form the middle part of the foot, attaching the ankle to the toes. These bones are located between the phalanges of your toes and the tarsal bones in the hindfoot. A metatarsal foot fracture occurs when there is a break or crack in one of these metatarsal bones in the foot. However, it is one of the most common pediatric foot fractures that don’t usually require operative management. Children aged 5 or below are more likely to injure their first metatarsal bone, whereas the fracture of the 5th metatarsal bone is more common in children older than 5 years.
How Do Metatarsal Fractures Occur?
The most common causes of a metatarsal fracture include a fall from a height, a direct blow to the foot, ankle twisting, and repetitive stress.
Here are the two different types of metatarsal fractures:
Acute Metatarsal Fracture
An acute metatarsal fracture occurs when one experiences a sudden direct injury to the foot. For example, a break in one of the metatarsals can happen if someone steps on your child’s foot or drops something heavy onto his/her foot. Also, a severe twist of the ankle, kicking a hard object, or falling on the foot can cause the metatarsal bones to break.
In an acute metatarsal fracture, you may hear an audible snapping sound at the time of the break and feel immediate pain around the area of the injury. In addition, your child may develop swelling and bruising in that particular area. Moreover, the patient may have trouble walking or putting weight on the foot. In short, the ability to walk or tolerate weight on foot will depend on the mechanism or severity of the injury.
QUESTIONS AND ANSWERS
What is a fractured metatarsal in a child, and how is it diagnosed?
- Fractured Metatarsal: A fractured metatarsal is a break or crack in one of the long bones of the foot, known as metatarsals. These fractures can occur as a result of trauma or repetitive stress on the foot.
- Diagnosis: The diagnosis typically involves a physical examination and imaging studies. The healthcare provider will assess the child’s foot for tenderness, swelling, and deformity. X-rays are often used to confirm the presence and extent of the fracture.
What is the treatment for a child with a fractured metatarsal?
Treatment: The treatment approach for a fractured metatarsal in a child depends on the severity of the fracture:
- Conservative Treatment: For simple, non-displaced fractures, treatment may involve immobilizing the foot with a cast or boot and advising the child to avoid putting weight on the injured foot.
- Surgery (Rare): In more complex or displaced fractures, surgical intervention may be required to realign and stabilize the fractured bone with screws or plates.
What is the expected recovery time, and can the child return to physical activities or sports?
- Recovery Time: The recovery time for a fractured metatarsal varies depending on the location and severity of the fracture. Simple fractures may take around 6-8 weeks to heal, while more complex fractures may take longer.
- Return to Physical Activities: Whether a child can return to physical activities or sports depends on the nature of the fracture and the child’s progress in healing. It’s crucial to follow the healthcare provider’s guidance regarding when it is safe to resume physical activities to prevent re-injury.
It’s important for parents to seek medical attention for their child if they suspect a metatarsal fracture. Proper diagnosis and treatment are crucial to ensure the best possible outcome and minimize potential complications associated with this type of injury.
When children break bones, parents need to take them to the very best doctors. At the Medical City Children’s Orthopedics and Spine Specialists, we are the best. We specialize in children and their bones.
Metatarsal Bone Stress Fracture
A metatarsal bone stress fracture results from repetitive stress to one of the metatarsal bones. This can happen when your child participates in intense training exercises or runs for long distances. Additionally, these types of fractures can occur if one runs in ill-fitting shoes or continues to do workouts despite having foot pain.
In a stress fracture, the patient will develop the symptoms over time. First, your child may start to notice pain when walking or putting weight on the foot. These symptoms may fade after some time. However, if left unnoticed, the symptoms can worsen and the patient may experience persistent pain at the location of the fracture.
Different Types of Fifth Metatarsal Fractures
Fractures of the fifth metatarsal are usually caused by a direct blow or twisting of the foot or the ankle.
Here are the four common types of fifth metatarsal fractures:
Avulsion Fracture
The avulsion fracture occurs in the bone’s rear-most portion, the part that is closest to the ankle. Because the injury happens in a location where one of the ankle tendons (the peroneal tendon) attaches to the bone, the fracture results in the tendon pulling off a small piece of the bone. As a result, the bone can break into many tiny pieces. Nonetheless, most avulsion metatarsal fractures don’t require any surgical procedures. The most common treatment methods used to treat this type of injury include protective immobilization. However, the doctor may recommend surgery if the bones are unacceptably separated or dislocated.
Jones Fracture
The Jones fracture occurs near the back of the fifth metatarsal bone at the metaphyseal-diaphyseal junction. Since this area lacks proper blood supply, the fracture takes longer to heal than the fractures of other metatarsal bones. This type of foot injury occurs as a result of a traumatic event or a chronic overuse (repetitive stress) situation. Not to mention, a specific traumatic event can cause a sudden fracture and immediate pain at the location of the fracture. For example, turning the foot inwards towards the other foot can cause the bone to break. Your doctor may or may not recommend a surgical procedure depending on your child’s situation (age, activity level, medical condition, etc) and the severity of the injury. The non-surgical treatment involves casting for six to twelve weeks.
Head or Neck Fracture
A head or neck fracture can occur when one experiences a lower-force injury or direct blunt trauma. For instance, stubbing your little toe can cause this type of foot fracture. In order to determine the ideal treatment option, your foot surgeon will examine the bone properly before making a final decision.
Dancer’s Fracture
A true dancer’s fracture occurs when the middle part of the fifth metatarsal bone is cracked or broken. Doctors don’t usually recommend surgery for the dancer’s fracture unless there is an unacceptable separation or distortion of the bone ends.
Common Symptoms of Metatarsal Fractures
Below, we’ve put together a list of some of the most common symptoms of metatarsal fractures:
Acute Metatarsal Fracture:
- Audible sound at the time of injury
- Immediate sharp pain in the area of the fracture
- Swelling and bruising
- Difficulty walking, running, or putting weight on the foot
Stress Metatarsal Fracture:
- Pain in the foot that worsens over time
- Persistent pain that doesn’t diminish with rest
- Tenderness along the line of the 2nd or 3rd metatarsal bone
- Swelling around the area of the fracture
Nevertheless, in a metatarsal stress fracture, there is usually no bruising or audible cracking sound. The symptoms develop over time.
Diagnosis of A Metatarsal Fracture
Your doctor will first physically examine the area of injury. If he suspects a metatarsal fracture, he may suggest an X-ray of the affected foot. For the most part, acute metatarsal fractures are visible on X-ray. However, CT scanning or MRI scanning may be needed sometimes.
Stress fractures are not seen easily on X-ray. For this reason, your doctor may suggest a specialized ultrasound scan to determine the injury. He may also suggest MRI scanning.
Treatment For Metatarsal Fractures
The ideal treatment option for a metatarsal fracture depends on which bone is broken and how severe the injury is. In addition, he will see whether or not there is an unacceptable displacement of the bone. Most doctors will not recommend surgery unless there is a significant separation or displacement of the metatarsal bone.
- Painkillers – If your child has a broken or cracked metatarsal bone, he/she will have some pain and swelling. Due to this, your doctor may prescribe non-steroidal anti-inflammatory pain medicines. However, always talk with your doctor about any allergies your child may have before giving him any pain medicine.
- Application of Ice – Ice can work as a pain reliever. You should apply ice to the affected foot as soon as possible. Just wrap some ice cubes in a towel or plastic bag and press it on the injured part.
- Avoid Stressing The Foot – Please remember that the condition can become worse if repeated stress to the fractured bone continues. For this reason, make sure that your child doesn’t do any heavy physical activities or exercises until fully recovered. If needed, crutches may help.
- Immobilization – Some metatarsal fractures require a cast to heal. Also, your doctor may advise a supporting shoe or boot.
- Rest and Elevate – Keeping the foot raised will reduce swelling. You can place extra pillows and blankets under the leg to elevate the foot while sleeping. Rest is also very important to accelerate healing.
- Surgery – As mentioned earlier, a doctor will recommend surgery if the bones are significantly separated or displaced.
Please note that it can take anywhere between six to twelve weeks for your child to start doing playground activities or playing contact sports again after the injury. If at any stage, the pain gets worse, you should immediately seek medical advice.
How to Prevent Metatarsal Stress Fractures?
Here are some tips to prevent metatarsal stress fractures:
- Your child should wear well-fitting footwear that suits his running style.
- You should increase exercise intensity and duration in a slow and gradual manner.
- It’s better to avoid running on a painful foot.
Bottom Line
You should always consult with your doctor or for the very best, make an appointment to see one of our doctors at Medical City Children’s Orthopedics and Spine Specialists. We specialize in children and only children. And for your convenience, we have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX. if your child has persistent foot pain that doesn’t go away by resting it, please give us a call and make an appointment. Also, if there is swelling and the pain increases quickly, you should take your child to the emergency department. The doctor will carefully examine the condition and give you the right advice.
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Footnote:
Orthopaedic Trauma Association: Metatarsal Fracture
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