Toe and Metatarsal

Common Foot Problems

Toe and Metatarsal Fractures

The foot is an intricate structure of bones, muscles, tendons and other soft tissues. There are 26 bones in each foot, 14 toe bones (phalanges) and 5 bones in the midfoot (metatarsals). The toes and midfoot are common fracture sites and must be evaluated by a specialist. Consult Dr. Radovic for a proper diagnosis and treatment, even if an initial assessment was made in an urgent care facility or emergency room.

A fracture is a break or crack in the bone. There are two main categories of fractures – traumatic fractures and stress fractures.

Traumatic fractures, also known as acute fractures, are caused by a direct impact to the area of concern. For example, hitting your toe against a wall may cause an acute fracture. These fractures can be displace or non-displaced. The impact from a displaced fracture causes the bone to break and change position, or become dislocated.

Traumatic fractures include the following signs and symptoms:

  • A sound may be heard at the time of the break.
  • Pain may be felt at the place of impact when the fracture occurs, and possibly for two to three hours after the fracture. Pain is often relieved after several hours.
  • An abnormal change in direction or appearance of the toe.
  • Bruising and inflammation the following day.

The expression “if you can walk on it, it’s not broken” is not true. Evaluation by Dr. Radovic is always advised.

Stress fractures are small slivers or cracks in the bone, usually caused by repetitive impact. They most commonly affect athletes who suddenly increase their training intensity. Other causes of stress fractures may include an abnormal foot structure, deformities, osteoporosis or improper footwear. Stress fractures may lead to serious complications if left untreated.

Stress fractures include these symptoms:

  • Pain during or after normal activity.
  • Pain that is relieved when resting but returns with standing or activity.
  • "Pinpoint pain" (pain at the fracture site) when touched.
  • Swelling, but no bruising.
  • Some people think that foot fractures are untreatable, but this is not true. In fact, serious complications may result if a fractured toe or metatarsal bone is not treated by Dr. Radovic, such as:
  • A deformity in the bone structure may limit foot mobility or cause difficulty in fitting shoes.
  • Arthritis, as a result of a joint fracture, or angular deformities that develop when a displaced fracture is severe or left untreated.
  • Chronic pain and deformity.

Failure to heal may lead to surgery or chronic pain.

Toe fractures are most often traumatic fractures. Treatment options for traumatic fractures depend on the type of bone break and may include:

Rest. Sometimes rest is the only necessary treatment for a traumatic toe fracture.
Splinting. The toe may be fitted with a splint to prevent movement.
Rigid or stiff-soled shoe. Wearing a stiff-soled shoe helps keep the toe properly positioned.
"Buddy taping" the fractured toe to another toe may be helpful in select cases.

Surgery may be appropriate if the joint is affected or the break is badly displaced. Fixation devices such as rods, screws and pins are often involved in surgery.

Metatarsal bone fractures may be either stress or traumatic fractures. These fractures present certain complications.

For instance, arthritis may be developed from a fracture in the first metatarsal bone, behind the big toe. The big toe is used more often, and supports more weight than the other toes; so arthritis in that area can cause pain from walking, bending or even standing.

A Jones fracture is another type of break that occurs at the base of the fifth metatarsal, behind the pinky toe. When treatment is received from a non-specialist, a Jones fracture is often misdiagnosed as an ankle sprain, and misdiagnosis can lead to complications since sprains and fractures require different treatments. Dr. Radovic is an expert in identifying foot and ankle problems and will recommend the proper treatment.

Metatarsal fractures are treated depending on fracture type and severity and may include these options:

  • Rest. A stress or traumatic fracture of a metatarsal bone may sometimes by healed with rest alone.
  • Avoid the activity. Stress fractures are caused by repetitive stress from an activity, so an important method of healing is to avoid the activity that led to the fracture. Dr. Radovic may recommend crutches or a wheelchair to reduce weight from the foot and promote healing.
  • Immobilization. Casting, a rigid shoe or other forms of immobilization may help protect the fracture during healing.
  • Surgery. Traumatic fractures of the metatarsal bones sometimes require surgery, especially if the break is badly displaced.
  • Follow-up care. Dr. Radovic will provide a plan of care after surgical or non-surgical treatment, which may include physical therapy, exercises and rehabilitation leading to return to normal activities.
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