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What This Means to You

Foot Fracture (Metatarsal Fracture)

Of the 26 bones in your foot, 19 are toe bones and metatarsal bones.

Your foot is a complex structure made up of bones, muscles and tendons - and fractures of the toe and metatarsal bones are some of the most common foot injuries.

When a toe bone (phalange) or metatarsal bone (the long bones in the midfoot) is fractured or broken it can have a sever impact on your mobility and independence. These fractures can be divided into two categories.

Traumatic Fractures

Also called acute fractures, these breaks are caused by a direct blow or impact. Depending on the severity of the fracture, surgery may be required. Signs and symptoms of a traumatic fracture include:

  • You may hear a sound at the time of the break
  • "Pinpoint pain" (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later. Often the pain goes away after several hours
  • Deviation (misshapen or abnormal appearance) of the toe
  • Bruising and swelling the next day

It is not true that "if you can walk on it, it's not broken."

Stress Fractures

These tiny, hairline breaks often afflict athletes. or they can be caused by an abnormal foot structure, deformities, or osteoporosis. Improper footwear may also lead to stress fractures. Symptoms of stress fractures include:

  • Pain with or after normal activity
  • Pain that goes away when resting and then returns when standing or during activity
  • "Pinpoint pain" (pain at the site of the fracture) when touched
  • Swelling, but no bruising

Treatment of Toe Fractures

Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:

  • Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.
  • Splinting. The toe may be fitted with a splint to keep it in a fixed position.
  • Rigid or Stiff-Soled Shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned.
  • "Buddy Taping." "Buddy taping" the fractured toe to another toe is sometimes appropriate, but in other cases it may be harmful.
  • Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.

Treatment of metatarsal fractures

Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges.

Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include:

  • Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone.
  • Avoid the Offending Activity. Depending on the activity that caused the fracture, crutches or a wheelchair are sometimes required to offload weight from the foot to give it time to heal.
  • Immobilization, Casting, or Rigid Shoe. A stiff-soled shoe or other form of immobilization may be used to protect the fractured bone while it is healing.
  • Surgery. Some traumatic fractures of the metatarsal bones require surgery, especially if the break is badly displaced.
  • Follow-Up Care. Physical therapy, exercises and rehabilitation may be necessary to return to normal activities.

Fractures of the toe and metatarsal don't always feel like a major injury. However, because of serious potential consequences, it's important to have your skilled physician examine the injury. When treated properly, your recovery and rehabilitation will be more effective, helping you return to the activities you enjoy.

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