Metatarsal Injury & Surgery Options
Our bones are quite strong and do a remarkable job of providing structure, but they are not infallible. When subjected to excessive forces, either in a single traumatic event or repeatedly over time, cracks can develop. The foot and ankle bones, including the metatarsals, regularly endure substantial force loads, but overuse can lead to problems like stress fractures. When blunt physical force is considered, metatarsals can sustain a variety of other fractures. Not all breaks and fractures are equal. Toe bones receive tremendous amounts of stress from the forces that accompany walking and running, and are located in an area that is likely to be affected when someone drops something heavy. Due to this, our Medford, OR podiatric practice treats many patients for metatarsal fracture injuries. These injuries range in levels of severity, and understanding the nature of your specific injury will dictate what you can expect with regard to treatment and recovery.
An Overview of Midfoot InjuriesThe midfoot is marked by something known as the Lisfranc joint complex. In this area, there is a cluster of small bones that form an arch on the top of the foot. This is where the long metatarsal bones begin and extend to the toes. Everything is held in place by ligaments stretching across and down the foot. There are essentially three categories of midfoot injuries:
- Sprains – A sprain in the Lisfranc joint complex happens when a ligament is twisted beyond its intended range of motion. This results in pain and swelling.
- Fractures – Fractures are simply broken bones. There are various ways the bones in the midfoot can become fractured, including direct trauma (like a fall from height).
- Dislocations – Some Lisfranc injuries are ones wherein a metatarsal has become dislocated due to physical trauma.
The Basics of Metatarsal FracturesEach of your feet has 26 bones and five of those are metatarsals. These bones are the long ones that run across the midfoot, connecting the front and back. A fracture is simply another term that means break. There are two main categories when it comes to fractures:
- Traumatic fractures. This is an injury that happens when a bone is subjected to greater force in one moment than it can handle. Events that could cause this include seriously stubbing a toe, dropping a heavy item on your foot, or sustaining an injury while playing baseball or another sport.
- Stress fractures. Unlike a traumatic fracture, this type does not happen from a single event. A stress fracture is a tiny, hairline crack that develops because of repetitive stress. This is thought of as being an “overuse” injury and can be seen in athletes who run great distances.
Causes of Stress Fractures in MetatarsalsWhereas most people understand fractures caused by blunt physical trauma, stress fractures aren’t quite as universally understood. Let’s take a look at these particular fractures that can develop in the bones in your midfoot. Bones undergo a near constant process of generating and replacing tissue (known as “remodeling”). If activity levels are too great or too frequent, the breakdown of bone outpaces the body’s ability to repair and replace it. This results in weaker bones; ones which are then more vulnerable to stress fractures. A stress fracture is a thin, surface-level crack in a bone caused by overuse (often in conjunction with repetitive motion). The weight-bearing bones in the lower extremities are particularly vulnerable to these common overuse injuries because they absorb repetitive forces during activities like running, jumping, and even simply walking. Metatarsal stress fractures are most likely to develop in either the second or third metatarsals. This can be attributed to the fact they are often longer and thinner than the first metatarsal. This area of the foot sustains the greatest amount of impact whenever you push off the ground while walking or running. Accordingly, the most frequent causes of these stress fractures is a sudden increase in physical activities, either in frequency, duration, or intensity. The activity doesn’t even necessarily need to be particularly “athletic” for this injury to develop. Even excessive walking, if you normally walk on an infrequent basis, can lead to this problem. Some factors that increase the likelihood of a metatarsal stress fracture include:
- Poor conditioning. Instead of jumping into an activity too quickly, take time to gradually build up your body and prepare it ahead of time.
- Improper equipment. Make sure you choose shoes with ample shock-absorbing features, and then replace them when they are worn out.
- Bone insufficiency. Consume plenty of calcium and vitamin D in your diet to keep bones strong and dense.
- Change in surface. Going from a soft surface to a harder one can increase your injury risk, so you may need to lower your intensity or duration when doing so.