Metatarsal Fractures

The foot is a complex structure of our body constituted by 26 bones, more than 30 joints and several ligaments that maintain joint stability. From the anatomical point of view, the foot is typically divided into 3 main areas, the forefoot, midfoot and the rearfoot. The metatarsals are five bones (numbered I to V from inside to outside of the foot), that are part of the forefoot, with the paramount function of forming the main arches of the foot and supporting the ability of the foot to adapt to different terrains. The top part of the metatarsal bones articulates with the phalanges that constitute the toes, while the bottom part connects with the midfoot. Metatarsal fractures are unfortunately common and prevalently due to direct trauma to the forefoot, such as a fall of heavy objects on the foot. Lower-energy traumatic injuries are also possible and are typically reported due to repetitive stress to the metatarsal bones (stress fractures), or a twisting motion performed on a fixed forefoot (more common in multidirectional sports). Patients with this type of injury tend to complain of pain in the forefoot, swelling, bruising, potential deformity (depending on the severity of the fracture), and decreased weight-bearing capacity. Based on the clinical presentation and injury specifics, metatarsal injuries can be managed either conservatively or surgically.

Non-surgical management

The non-surgical management is suggested in cases of low-level injuries, usually minor non-displaced fractures. The treatment, often guided by imaging (x-ray or computed tomography – CT), includes reduction and splinting of the injured area. A cast or a boot is typically prescribed together with the use of crutches to offload the joint for 4-6 weeks, depending on the severity of the injury. After this period of immobilisation, rehabilitation is usually initiated to facilitate the recovery of mobility, improve joint stability, increase muscle strength, optimise movement quality and finally return to performance. In Isokinetic, after the initial consultation with one of our specialised doctors, your recovery plan will take place in four different environments, such as the pool, gym, movement analysis and retraining room, and finally, the on-field rehabilitation to achieve your maximal functional recovery possible and prevent a relapse.

surgical management

In case of more severe injuries that significantly compromise joint stability and functioning, surgical management is recommended. Different procedures (e.g.: stabilisation with external or minimal internal fixation) can be implemented depending on the specifics of the injury itself, and they are always discussed in detail between the patient and the medical-surgical staff. After the injury, it is common for the patient to be prescribed a period of immobilisation utilising a cast, boot, and crutches to offload the joint and support the biological healing process. Rehabilitation should commence shortly after the surgical procedure, to support the symptoms reduction, mobility recovery and joint stability. Like the non-surgical management, in Isokinetic your recovery will take place in our four different environments (pool, gym, movement analysis room and on-field rehabilitation) to achieve your maximal functional recovery possible.

Metatarsal Fractures