Metatarsal fracture refers to the disruption of the physical integrity of any one or multiple of the five metatarsal bones. The metatarsal fracture may result from blunt trauma, possibly sustained in motor vehicle accidents. Stress fractures of the metatarsal bones are increasingly seen in athletes who subject their feet to repetitive, heavy impacts. Fractures of the metatarsal bones may also be related to systemic diseases like osteopenia and osteoporosis.
There are three types of metatarsal fracture (MF), and affected individuals may provide the following anamnestic data:
- Acute or traumatic MF is the result of a traumatic impact on either of the metatarsal bones. In such cases, mechanical forces sustained during motor vehicle accidents or falls have exceeded the maximal resistance of the respective bone(s) and led to MF. Patients presenting with traumatic MF thus generally report to have been involved in such accidents. Of note, these patients may suffer from polytrauma and life-threatening injuries unrelated to MF. A thorough clinical examination is required to identify possible damage to internal organs and vascular structures.
- Stress fractures of the metatarsal bones may be seen in patients who pursue high load-bearing activities associated with repetitive impacts on their feet, e.g., runners, soccer and tennis players, among others   . It has been shown that individuals suffering from pes cavus are predisposed for MF .
- Systemic pathologies such as osteopenia and osteoporosis or rheumatoid arthritis may predispose for pathological MF  . These entities may or may not have been diagnosed previously, and affected individuals may report bone pain (including but not limited to the affected foot), prior pathological fractures, or morning stiffness and joint disease, respectively.
Intense foot pain predominates the clinical picture. Foot pain generally aggravates during weight bearing activities but may be present at rest. Furthermore, surrounding soft tissues are tender and contact or slight pressure may elicit pain. Pressure pain is most severe at the site of the fracture. Focal swelling is often noted .
Entire Body System
One year later, the patient had no pain and had returned to ballroom dancing, a hobby which she performed five days a week, with no difficulties. [ncbi.nlm.nih.gov]
Symptoms: There is diffuse pain on activity, which usually subsides with rest initially. With time, pain becomes localized to the area and persists, even at rest. [docpods.com]
What if the pain gets again worse? If the pain gets worse then you should seek medical advice. [patient.info]
- Foot Pain
Pedorthists Foot Scans Custom Orthoses Depth Footwear Foot Shapes High Arch Flat Foot Fitting Advice Foot Injuries Plantar Fasciitis Shin Splits Achilles Tendonitis Corns Posterior Tibial Tendonitis Runner's Toe Morton's Neuroma Foot Pathologies Bunion Metatarsalgia [wherefeetloveus.com]
[…] outcomes limited information available in literature Complications Malunion may lead to transfer metatarsalgia or plantar keratosis treat with osteotomy to correct deformity Please rate topic. [orthobullets.com]
Chou, “Surgical Management for Intractable Metatarsalgia,” Foot and Ankle International, Vol. 16, No. 6, 1995, pp. 322-327. [ 3 ] A. E. Sanchez, C. V. Vicent, P. Alcantara and A. J. [dx.doi.org]
FractureICD-9 825.25 (closed fracture of metatarsal bone) 825.35 (open fracture of metatarsal bone) Metatarsal FractureEtiology / Epidemiology / Natural History Untreated displaced fractures (espcially sagittal plane angulation) can lead to transfer metatarsalgia [eorif.com]
- Bone Disorder
[…] bones, Fracture metatarsal bone and/or tarsal bone (& one or more) (disorder), Fracture metatarsal bone and/or tarsal bone (& one or more), fracture of one or more tarsal and metatarsal bones (diagnosis), Fracture of one or more tarsal and metatarsal bones [fpnotebook.com]
Third, patient specific factors such as intrinsic bone disorders or metabolic disorders were not assessed. Fourth, despite a mean follow-up of almost 2 years, refractures have been reported to occur even after that time range . [bmcmusculoskeletdisord.biomedcentral.com]
Plain radiography is the mainstay of MF diagnosis. In order to evaluate the condition of the metatarsal bones, anteroposterior and oblique radiographs should be obtained. Fractures of the metatarsal bones appear as radiolucent lines that interrupt the continuity of the physiological osseous structure. Any metatarsal bone may be affected, and patients may present with multiple MFs. Joint involvement should be assessed.
MFs most commonly involve the fifth metatarsal . In this context, incidence rates of tuberosity avulsion fractures are higher than those of Jones fractures and diaphyseal stress fractures. The latter two are easily confounded . They are, however, associated with different therapeutic regimens and prognoses and thus require a thorough workup. According to Lawrence and Botte, Jones fractures occur at the distal limit of the joint between the fourth and the fifth metatarsal. Diaphyseal stress fractures, in contrast, affect the proximal diaphysis  . Stress fractures are often associated with intramedullary sclerosis, cortical hypertrophy and periosteal reaction .
Of note, stress fractures may not be depictable using plain radiography. A strong suspicion of MF despite the absence of radiographic anomalies thus justifies magnetic resonance imaging or scintigraphic examinations . Due to radiation exposure, computed tomography scans should be reserved for specific indications. Sonography may be of use if the examiner has sufficient experience . In any case, imaging studies lay the foundation for treatment planning .
Further diagnostic measures may be indicated to identify underlying systemic disorders, e.g., laboratory analysis of blood samples, bone density measurements, and additional diagnostic imaging.
Our results suggest that the Ilizarov mini external fixator should be considered not only for temporary treatment, but also for the entire duration of treatment of first metatarsal fractures associated with severe soft tissue damage. [ncbi.nlm.nih.gov]
[…] surgical treatment and 36 had conservative treatment. [podiatrytoday.com]
A delayed diagnosis increases the likelihood of nonunion and the possible need for surgical treatment. In athletes, sometimes surgical treatment is considered even in acute settings, just to ensure the healing process is predictable. [verywellhealth.com]
NEXT: Treatment Options › Treatment Options The first metatarsal, which connects to the big toe, is the most important and fractures of the first metatarsal usually require surgery. [mdmercy.com]
Unfortunately, no standardized treatment regimen was applied. Konkel et al.  treated 35 type I and 10 type II fractures nonoperatively. Treatment varied from no treatment to immobilization in a short leg cast. [bmcmusculoskeletdisord.biomedcentral.com]
Treatment and prognosis In general, these fractures can be treated conservatively, and heal well 2. For large or very displaced fragments with intra-articular extension then operative fixation may be indicated. [radiopaedia.org]
Answer Explanation Fractures of the fifth metatarsal are the most common of all foot fractures. 1 Emergency physicians must understand the different types of fractures as management and prognosis differs widely. [aliem.com]
Most metatarsal fractures have a good prognosis; however, Jones fractures have a high rate of nonunion and Lisfranc injuries can result in chronic symptoms. [accessmedicine.mhmedical.com]
Etiology Zone 1 fractures are tuberosity avulsion fractures, also called pseudo-Jones fractures, and occur when the hindfoot gets forced into inversion during plantarflexion. This acute injury pattern may occur after an athlete lands awkwardly after [ncbi.nlm.nih.gov]
Various studies have evaluated the etiology of each type of proximal fifth metatarsal fracture as well as the best therapeutic options. [podiatrytoday.com]
Epidemiology/ Etiology 5 to 6% of all fractures treated in primary care are metatarsal fractures. It are the most common injuries of the foot. [physio-pedia.com]
BACKGROUND: A paucity of data exists studying the epidemiology of fifth metatarsal fractures. [ncbi.nlm.nih.gov]
[…] subsequent encounter for fracture with nonunion P- subsequent encounter for fracture with malunion S- sequela Metatarsal FractureICD-9 825.25 (closed fracture of metatarsal bone) 825.35 (open fracture of metatarsal bone) Metatarsal FractureEtiology / Epidemiology [eorif.com]
Athletics Epidemiology Foot Injuries Soccer Stress Fracture View Full Text Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center [bjsm.bmj.com]
Epidemiology of Lower Extremity Stress Fractures in the United States Military. Mil Med. 2016 Oct. 181 (10):1308-13. [Medline]. Hetsroni I, Nyska M, Ben-Sira D, Mann G, Segal O, Maoz G, et al. [emedicine.medscape.com]
Jones fractures: pathophysiology and treatment. JBJS Rev. 2015;3(7):00100. doi:10.2106/JBJS.RVW.N.00100 Baumbach SF, Prall WC, Kramer M, Braunstein M, Böcker W, Polzer H. [verywellhealth.com]
Pathophysiology As in all metatarsal fractures, first and central metatarsal fractures occur with either direct or indirect trauma.21,28 Rarely, crush injuries may cause these fractures and are often associated with soft-tissue and other bony injury.28,31 [journals.sagepub.com]
Epidemiology incidence frequent injury encountered in primary care setting base of 5th metatarsal fractures account for 25% of all metatarsal fractures of which, 90% are zone 1 fractures demographics athletes, military recruits, and manual laborers Pathophysiology [orthobullets.com]
Clin Orthop Relat Res 466:1444–1448 Lareau CR, Anderson RB (2015) Jones fractures pathophysiology and treatment. JBJS Rev 3(7):e4 Lawrence SJ, Botte MJ (1993) Jones’ fractures and related fractures of the proximal fifth metatarsal. [jeo-esska.springeropen.com]
Because of the swollen foot and fracture comminution, an operation using the Ilizarov mini external fixator was performed to prevent further damage to the soft tissue. [ncbi.nlm.nih.gov]
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. [physioroom.com]
How can I help prevent a fifth metatarsal fracture? Most foot fractures are caused by accidents that are not easy to prevent. However, shoes that fit well and give good support can help prevent injury. Developed by RelayHealth. [summitmedicalgroup.com]
Prevention of Metatarsal Fractures This type of injury can be very hard to prevent because it is usually caused by sudden direct trauma to the foot. [medic8.com]
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- Ochenjele G, Ho B, Switaj PJ, Fuchs D, Goyal N, Kadakia AR. Radiographic study of the fifth metatarsal for optimal intramedullary screw fixation of Jones fracture. Foot Ankle Int. 2015; 36(3):293-301.