The metatarsals are the five long bones on the top of the foot, between the toes and the tarsal bones at the arch near the ankle. The metatarsals are numbered one through five, with the first metatarsal connected to the big toe. Metatarsal fractures typically occur due to traumatic foot injury or overuse. Treatments for metatarsal bone fractures vary, depending on the location and severity of the fracture.
Relative Rest
Stress fractures--small cracks in the bones--commonly occur in the second and third metatarsals, according to the American Academy of Orthopaedic Surgeons. These overuse injuries often occur due to an abrupt increase in physical activity such as a marked increase in running distance or undertaking an intensive training regimen. The primary treatment for metatarsal stress fractures is relative rest. The term "relative" refers to the fact that weight bearing is not restricted. Resting the foot involves taking a three- to four-week break from the activities that led to the fracture. Changes in training methods and footwear may be advised to prevent a recurrence of the fracture.
Protective Footwear
A hard-soled shoe may be used to provide extra support during healing of a metatarsal fracture, notes the American College of Foot and Ankle Surgeons on the patient information website Foot Health Facts. This type of treatment is used for metatarsal fractures in which the bone pieces remain aligned and are unlikely to be forced out of alignment by weight bearing.
Walking Cast or Foot Brace
Metatarsal fractures causing significant pain and those that are located in an area of the foot prone to pressure that would impede healing typically require a foot brace or walking cast. These devices provide a greater degree of support for the injured bone than protective footwear and limit bone movement. Doctors may advise the use of crutches to limit weight bearing until the fracture heals, notes the American Academy of Orthopaedic Surgeons.
Surgery
Proximal fractures of the metatarsals--close to where they meet the tarsal bones--are termed Lisfranc fractures. These fractures are characteristically unstable and significantly interfere with normal alignment and function of the foot. According to the American Academy of Orthopaedic Surgeons, treatment for Lisfranc fractures often involves surgical placement of pins, screws or wires to hold the bones in place during the healing process. Other types of metatarsal fractures in which the bones are significantly out of alignment or are unlikely to stay in alignment may also require surgery to fix the bones in place with plates, screws or similar devices. Metatarsal fractures in which a piece of bone protrudes through the skin require surgery for cleansing of the wound and bone fixation.
References
- Foot Health Facts: Toe and Metatarsal Fractures
- American Academy of Orthopaedic Surgeons: Toe and Forefoot Fractures
- American Academy of Orthopaedic Surgeons: Stress Fractures of the Foot and Ankle
- American Academy of Orthopaedic Surgeons: Lisfranc (Midfoot) Fractures
- eOrthopod: Adult Foot Fracture, Treatments
