Fractured foot pictures: Pictures, Symptoms, Treatment & Healing Time
How to Tell if Your Foot is Broken: Symptoms & Treatment Options
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Foot and ankle bones
A broken foot is an injury to the bone. You may experience a broken foot during a car crash or from a simple misstep or fall. The seriousness of a broken foot varies. Fractures can range from tiny cracks in your bones to breaks that pierce your skin.
Treatment for a broken foot depends on the exact site and severity of the fracture. A severely broken foot may require surgery to implant plates, rods or screws into the broken bone to maintain proper position during healing.
Symptoms of a Broken Foot
If you have a broken foot, you may experience some of the following signs and symptoms:
- Immediate, throbbing pain
- Pain that increases with activity and decreases with rest
- Difficulty in walking or bearing weight
When to see a doctor if you think your foot is broken
See a doctor if there is obvious deformity, if the pain and swelling don’t get better with self-care, or if the pain and swelling gets worse over time. Also, see a doctor if the injury interferes with walking.
Common Causes of a Broken Foot
The most common causes of a broken foot include:
- Car accidents. The crushing injuries common in car accidents may cause breaks that require surgical repair.
- Falls. Tripping and falling can break bones in your feet, as can landing on your feet after jumping down from just a slight height.
- Impact from a heavy weight. Dropping something heavy on your foot is a common cause of fractures.
- Missteps. Sometimes just putting your foot down wrong can result in a broken bone. A toe can get broken from stubbing your toes on furniture.
- Overuse. Stress fractures are common in the weight-bearing bones of your feet. These tiny cracks are usually caused over time by repetitive force or overuse, such as running long distances. But they can also occur with normal use of a bone that’s been weakened by a condition such as osteoporosis.
You may be at higher risk of a broken foot or ankle if you:
- Participate in high-impact sports. The stresses, direct blows and twisting injuries that occur in sports such as basketball, football, gymnastics, tennis and soccer can causes foot fractures.
- Use improper technique or sports equipment. Faulty equipment, such as shoes that are too worn or not properly fitted, can contribute to stress fractures and falls. Improper training techniques, such as not warming up and stretching, also can cause foot injuries.
- Suddenly increase your activity level. Whether you’re a trained athlete or someone who’s just started exercising, suddenly boosting the frequency or duration of your exercise sessions can increase your risk of a stress fracture.
- Work in certain occupations. Certain work environments, such as a construction site, put you at risk of falling from a height or dropping something heavy on your foot.
- Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and foot injuries.
- Have certain conditions. Having decreased bone density (osteoporosis) can put you at risk of injuries to your foot bones.
Complications from a Broken Foot
Complications of a broken foot are uncommon but may include:
- Arthritis. Fractures that extend into a joint can cause arthritis years later. If your foot starts to hurt long after a break, see your doctor for an evaluation.
- Bone infection (osteomyelitis). If you have an open fracture, meaning one end of the bone protrudes through the skin, your bone may be exposed to bacteria that cause infection.
- Nerve or blood vessel damage. Trauma to the foot can injure adjacent nerves and blood vessels, sometimes actually tearing them. Seek immediate attention if you notice any numbness or circulation problems. Lack of blood flow can cause a bone to die and collapse.
These basic sports and safety tips may help prevent a broken foot:
- Wear proper shoes. Use hiking shoes on rough terrain. Wear steel-toed boots in your work environment if necessary. Choose appropriate athletic shoes for your sport.
- Replace athletic shoes regularly. Discard sneakers as soon as the tread or heel wears out or if the shoes are wearing unevenly. If you’re a runner, replace your sneakers every 300 to 400 miles.
- Start slowly. That applies to a new fitness program and each individual workout.
- Cross-train. Alternating activities can prevent stress fractures. Rotate running with swimming or biking.
- Build bone strength. Calcium-rich foods, such as milk, yogurt and cheese, really can do your body good. Taking vitamin D supplements also can help.
- Use night lights. Many broken toes are the result of walking in the dark.
- Declutter your house. Keeping clutter off the floor can help you to avoid trips and falls.
Diagnosing a Broken Foot
During the physical exam, your doctor will check for points of tenderness in your foot. The precise location of your pain can help determine its cause. They may move your foot into different positions, to check your range of motion. You may be asked to walk for a short distance so that your doctor can examine your gait.
If your signs and symptoms suggest a break or fracture, your doctor may suggest one or more of the following imaging tests.
- X-rays. Most foot fractures can be visualized on X-rays. The technician may need to take X-rays from several different angles so that the bone images won’t overlap too much. Stress fractures often don’t show up on X-rays until the break actually starts healing.
- Bone scan. For a bone scan, a technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to your bones, especially the parts of your bones that have been damaged. Damaged areas, including stress fractures, show up as bright spots on the resulting image.
- Computerized tomography (CT). CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body. CT scans can reveal more detail about the bone and the soft tissues that surround it, which may help your doctor determine the best treatment.
- Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your foot and ankle together. This imaging helps to show ligaments and bones and can identify fractures not seen on X-rays.
Treating a Broken Foot
Treatments for a broken foot will vary, depending on which bone has been broken and the severity of the injury.
Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others).
After your bone has healed, you’ll probably need to loosen up stiff muscles and ligaments in your feet. A physical therapist can teach you exercises to improve your flexibility and strength.
Surgical and other procedures
- Reduction. If you have a displaced fracture, meaning the two ends of the fracture are not aligned, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
- Immobilization. To heal, a broken bone must be immobilized so that its ends can knit back together. In most cases, this requires a cast.
Minor foot fractures may only need a removable brace, boot or shoe with a stiff sole. A fractured toe is usually taped to a neighboring toe, with a piece of gauze between them.
- Surgery. In some cases, an orthopedic surgeon may need to use pins, plates or screws to maintain proper position of your bones during healing. These materials may be removed after the fracture has healed if they are prominent or painful.
Preparing for your appointment for a Broken Foot
You will likely initially seek treatment for a broken foot in an emergency room or urgent care clinic. If the pieces of broken bone aren’t lined up properly for healing, you may be referred to a doctor specializing in orthopedic surgery.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you’ve had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
For a broken ankle or foot, basic questions to ask your doctor include:
- What tests are needed?
- What treatments are available, and which do you recommend?
- If I need a cast, how long will I need to wear it?
- Will I need surgery?
- What activity restrictions will need to be followed?
- Should I see a specialist?
- What pain medications do you recommend?
Don’t hesitate to ask any other questions you have.
What to expect from your doctor
Your doctor may ask some of the following questions:
- Was there a specific injury that triggered your symptoms?
- Did your symptoms come on suddenly?
- Have you injured your feet in the past?
- Have you recently begun or intensified an exercise program?
What to do in the meantime
If your injury isn’t severe enough to warrant a trip to the emergency room, here are some things you can do at home to care for your injury until you can see your doctor:
- Apply ice for 15 to 20 minutes at a time, every three to four hours to bring down the swelling.
- Keep your foot elevated.
- Don’t put any weight on your injured foot.
- Lightly wrap the injury in a soft bandage that provides slight compression.
Jones fracture: Causes, symptoms, and treatment
A Jones fracture refers to a break between the base and shaft of the fifth metatarsal bone of the foot. The fifth metatarsal is the long bone on the outside of the foot that connects to the smallest toe.
A Jones fracture is a common type of metatarsal fracture and is the most severe type of fracture that can occur in this bone.
This fracture takes its name from the orthopedic surgeon, Sir Robert Jones, who first reported and treated the injury in 1902.
Share on PinterestA Jones fracture is a break in the bone that runs along the outside of the foot.
A Jones fracture occurs in a part of the foot known as the metaphyseal-diaphyseal junction.
This area is between the base and shaft of the fifth metatarsal, a long bone that runs along the outside of the foot from the smallest toe to the ankle.
The area receives less blood than other regions of the foot, which can make healing difficult.
Typically, this type of fracture results from stress on the bone caused by repeated motion, but it may also result from overuse or a sudden acute injury.
What are metatarsals?
The metatarsal bones are the long bones on the top of the foot that connect the ankle with the toes. There are five metatarsals in each foot. Each metatarsal bone has a base located next to the heel, a shaft, a neck, and a head.
The fifth metatarsal is the metatarsal on the outside of the foot that connects the ankle with the little toe.
It is slightly different from the other metatarsal bones. It bulges slightly at its base, while the other metatarsals do not.
The metatarsal bones help people balance while standing and walking. Because these bones get much more use than other bones, it is easy to injure them through overuse. Sudden acute injuries of the metatarsals are common after a sudden impact or severe twist of the foot.
A Jones fracture has many of the same symptoms as other types of fractures. A person with a Jones fracture may know they have injured their foot right away if the injury is sudden and causes immediate symptoms.
These symptoms include:
- pain and swelling on the outside of the foot at the base of the little toe
- problems walking
Share on PinterestThree types of fracture can affect the 5th metatarsal, but the Jones is the most severe.
A Jones fracture is one of three basic types of fracture that can affect the fifth metatarsal.
The other two types of fractures in the fifth metatarsal are:
Avulsion fracture: This fracture often happens with ankle sprains. It occurs at the base of the fifth metatarsal.
It usually occurs when there is a traumatic pulling of a tendon or ligament from the end of the metatarsal.
The fracture is always transverse, with a horizontal fracture line, according to the American Association of Orthopaedic Surgeons (AAOS). It usually results in little to no displacement.
Spiral or oblique shaft fracture: Trauma or stress placed on the bone closer to the fifth toe can cause a spiral or oblique fracture. This fracture is very unstable and may result in displacement.
Anyone who suspects they have a fracture should see a foot and ankle specialist as soon as possible.
If an injury is acute, which means it happens suddenly rather than over an extended period, seek medical care promptly.
Also, seek urgent medical attention if any of the following symptoms occur:
- a worsening of swelling, pain, numbness, or tingling in the affected leg, ankle, or foot
- purple skin on the leg or foot
A medical professional can determine whether a person has a Jones fracture or another type of metatarsal fracture, and they can provide appropriate treatment.
A Jones fracture can be troublesome and is often slow to heal. It is essential to get a correct diagnosis to ensure proper management.
To make a formal diagnosis of a Jones fracture, the doctor will:
- ask how the injury happened or when the pain started
- examine the foot
- assess the location of the pain by pressing on different areas of the foot
- take X-rays and other imaging scans
Treatment will depend on several factors, including:
- the individual’s activity level
- the severity of the break
- the overall health of the person
People can begin caring for a Jones fracture even while waiting for a doctor’s care.
As soon as pain occurs, a person can perform the RICE method to reduce pain and swelling.
The RICE method involves:
- Resting the injury
- Icing areas of pain and swelling with an ice pack or ice wrapped in a cloth
- Compressing the affected area with an elastic wrapping
- Elevating the injured foot above the level of the heart
These methods might help prevent a Jones fracture from getting worse while waiting for treatment.
Where possible, the treatment will be nonsurgical.
Share on PinterestA person may need to wear a foot support for several weeks while a Jones fracture heals.
Treatment typically involves wearing a non-weight-bearing cast to support the foot for about 6 to 8 weeks.
This is roughly the time it takes for a Jones fracture to heal.
However, a Jones fracture is often slow to heal or resistant to healing, and there is a risk of reinjury. Sometimes, a doctor may recommend surgery
According to an article published in the journal American Family Physician, a doctor may recommend surgery for some types of fracture or if the person is an elite athlete.
The incision required to repair a Jones fracture is minimal. This means that the surgeon can operate on a person on an outpatient basis, using general or local anesthesia.
Surgeons commonly repair these fractures by inserting a screw, rod, or plate.
During the procedure, the surgeon uses X-rays to ensure proper screw placement. The screw crosses the site of the fracture and squeezes the ends of it together.
Sometimes, a person may need a bone graft, particularly if they have experienced repeated fractures that have not healed with other treatment. In these cases, a surgeon may need to make a separate incision to perform the bone graft.
Since there is limited blood flow to the area, a Jones fracture has a higher chance of not healing than other metatarsal fractures, unless a person has surgical treatment.
If a person puts weight on the fracture, displacement can result. This means the ends of the bones do not line up correctly. In this case, too, surgery may be necessary.
Complications of surgery include:
- problems related to surgery and anesthesia, such as blood clots
- the need for repeated surgery
- refracturing after healing
- muscle atrophy
- continued pain and swelling
The healing time for a Jones fracture depends on the treatment method, the severity of the fracture, and the individual. With a cast, a Jones fracture usually takes 6 to 8 weeks to heal, but it can take up to 12 weeks.
However, between 15 and 20 percent of Jones fractures may not heal without surgery.
A person who has had surgery to repair a Jones fracture can expect a return to all activity, including sports, approximately 4 months after surgery.
However, the doctor may recommend a period of physical therapy to recondition the injured area.
More severe fractures that require bone grafting may require longer recovery times.
Tips and exercises for a good recovery
Some tips for a successful recovery include:
- keeping all weight off the foot for as long as the doctor recommends
- raising the foot while seated whenever possible
- managing any pain with ibuprofen after the first 24 hours
Following all of the doctor’s recommendations and guidelines will increase the chance of a successful recovery.
Do You Have a Broken or Sprained Foot?
It can happen while doing something as simple as walking, taking a misstep or exercising. Before you know it, you have a broken or sprained foot. And while they both hurt and can prevent you from engaging in activities, all the same, these are two different injuries that require different treatments, so being able to tell one from the other is important to help you heal.
Our medical experts can easily determine your condition and discuss options with you. If you think you’ve injured your foot in any way, head to the affordable walk-in clinics that make up the UrgentMED network of Southern California. Keep reading to learn how to tell if you have a broken or sprained foot.
Differentiating between the symptoms of a broken foot and sprained foot can be tricky because they are very similar and can be equally painful from the start. If you’ve broken your foot, you will experience immediate pain and swelling, along with bruising and occasional numbness. The pain will usually be so intense that walking will not be physically possible. In some cases, you may experience shock and will not be able to notice the pain immediately.
Similarly, foot sprains can also cause severe pain, swelling and bruising. In some cases, you are also unable to walk from a sprained foot depending on how bad the injury is.
Do you happen to remember the sound you heard when the accident occurred? If you sprained your foot, you may have heard a popping sound. With a broken foot, however, you would have heard a cracking sound that may have been louder and more obvious.
Treatments Are Different
If the doctor determines your foot is sprained, then the treatment will be to rest, ice the injured area, compress the swelling and elevate the injured area. He or she may also suggest you take anti-inflammatory medications. A sprained foot will heal on its own with time, so long as the foot is rested and not used for intense activities during the healing process.
The treatment for a broken foot is based on its severity and the location of the fracture. There are generally understood to be different fracture types, each varying in severity and treatment required. For example, a compound fracture, in which the skin breaks and the broken bone is exposed, will require more intensive remedial measures than a stable or a hairline fracture, in which the break is minimal.
Along with rest and medications, you may need a cast, brace, splint, or boot for your broken foot. In a worst-case scenario, you will need surgery in order to repair any damages to your foot and the bone structure may need to be permanently braced or altered.
Seeking Help for a Broken or Sprained Foot
If you suspect you have broken or sprained your foot, visit an UrgentMED clinic immediately. The medical professionals at UrgentMED – the largest urgent care network in Southern California – are ready to help you seven days a week. They will be able to quickly examine your broken or sprained foot on a walk-in basis at any of our 19 convenient Southern California locations.
If needed, UrgentMED provides on-site physical therapy at our West Los Angeles Urgent Care. We accept over 15 private insurance plans as well as Medicaid. Do not hesitate to seek medical help if you find yourself injured with a sprain or a broken bone. Find UrgentMED clinic nearest to you to address all of your health concerns today.
Fifth Metatarsal Fracture – Broken 5th Metatarsal | Foot Health Facts
What Is a Fifth Metatarsal Fracture?
Fifth metatarsal fractures (breaks) are common foot foot injuries. The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe. Two types of fractures that often occur in the fifth metatarsal are:
- Avulsion fracture. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain.
- Jones fracture. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress or trauma. They are less common and more difficult to treat than avulsion fractures. Other types of fractures can occur in the fifth metatarsal. Examples include midshaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.
Symptoms of a Fifth Metatarsal Fracture
Avulsion and Jones fractures have the same signs and symptoms. These include:
- Pain, swelling and tenderness on the outside of the foot
- Difficulty walking
Diagnosis of a Fifth Metatarsal Fracture
Anyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle surgeon as soon as possible for proper diagnosis and treatment. To arrive at a diagnosis, the surgeon will ask how the injury occurred or when the pain started. The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain. The surgeon will also order x-rays. Because a Jones fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed.
Until you are able to see a foot and ankle surgeon, the RICE method of care should be performed:
- Rest: Stay off the injured foot. Walking may cause further injury.
- Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Compression: An elastic wrap should be used to control swelling.
- Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.
The foot and ankle surgeon may use one of these nonsurgical options for treatment of a fifth metatarsal fracture:
- Immobilization. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot or stiff-soled shoe. Crutches may also be needed to avoid placing weight on the injured foot.
- Bone stimulation. A pain-free external device is used to speed the healing of some fractures. Bone stimulation, most commonly used for Jones fractures, may be used as part of the treatment or following an inadequate response to immobilization.
When Is Surgery Needed?
If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.
Jones fracture | Radiology Reference Article
A Jones fracture is an extra-articular fracture at the base of the fifth metatarsal bone.
It is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension.
The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion 5.
Jones fracture is located at the metadiaphyseal junction, approximately 2 cm (1.5-3 cm) from the tip of the 5th metatarsal, and has a predominantly horizontal course. It should not extend distally, nor should it extend to involve the articular surfaces.
Treatment and prognosis
In contrast to avulsion fractures, Jones fractures are prone to non-union (with rates as high as 30-50%) and almost always take longer than two months to heal 2.
As displacement of the fracture can be increased with persistent weight bearing, immobilization is important as part of the initial therapy, with a non-weight bearing cast for 6-8 weeks. Indications for non-operative management include undisplaced fractures and fractures in patients with limited activity (i.e. recreational athletes) 7.
Operative management is indicated in patients that are elite or competitive athletes or in non-operatively managed fractures when delayed union has occurred 7,8. Management includes either intra-medullary screw fixation or open reduction and internal fixation (ORIF is also the main management option as a salvage procedure when there is non-union following screw fixation) 7. The outcomes are similar with almost 100% union rates 7.
Internal fixation and even bone grafting may be required in cases of non-union, or where the fracture is significantly displaced.
History and etymology
It was first described by Sir Robert Jones (1857-1933), Welsh orthopedic surgeon, in 1902 3,6.
A number of fractures occur at the base of the 5th metatarsal (see fractures of the proximal fifth metatarsal) as well as entities which mimic fractures. These include:
Metatarsal Fractures | Broken Metatarsal | Symptoms, Causes and Treatment
Where are the metatarsal bones?
The metatarsal bones are some of the most commonly broken (fractured) bones in the foot. There are five metatarsal bones in each foot. They are the long slim bones which run the length of the foot to the base of the toes. For more information on foot anatomy, see the separate leaflet called Heel and Foot Pain (Plantar Fasciitis).
A metatarsal fracture is a break in one of the five long bones which form the middle part of your foot.
5th metatarsal fracture
The fifth metatarsal bone is the most common metatarsal bone to be fractured in sudden (acute) injury to the foot. It may be broken at various points along its length, depending on the mechanism of injury. The other metatarsal bones can also be broken. The first, second and fifth metatarsals are the most commonly injured in sport. Several well-known footballers have had metatarsal fractures in recent years.
Are there different types of break?
Breaks (fractures) can be acute, or caused immediately by injury. They can also occur over a longer period of time, when they are called stress fractures.
An acute metatarsal fracture may be open or closed, and displaced or not displaced:
- Open or closed: an open fracture is one where the skin is broken over the fracture so that there is a route of possible infection from the outside into the broken bones. This is a more serious type of fracture, with more damage to the soft tissues around it making treatment and healing more complicated. Specialist assessment is needed.
- Displaced or not displaced: a displaced fracture is one where, following the break, the bones have slipped out of line. A displaced fracture needs specialist care, as the bones will need to be properly lined up and stabilised. This may involve an anaesthetic and some kind of metal pinning or plating to the bones.
Acute metatarsal fracture is usually caused by a sudden forceful injury to the foot, such as dropping a heavy object on to the foot, a fall, kicking against a hard object when tripping, or from a sporting injury.
A stress fracture is a hairline break in a bone, caused by repetitive stress. This is cracking which goes only partway through the bone. There may be a single split in the bone, or multiple small splits. The hairline break or breaks do not go through the full thickness of the bone, so stress fractures are not generally displaced. However, several small stress fractures can develop around the same area, over time.
What causes metatarsal fractures?
Acute metatarsal fractures
- These can be caused by direct injury to the foot. This may happen, for example, through someone stepping on or kicking the foot, by dropping something on to the foot or by falling on to the foot.
- Twisting of the foot or the ankle can also cause fractures of the base of the fifth metatarsal. In this injury, the twisting mechanism pulls on a strong ligament that attaches to the base of the fifth metatarsal which then pulls off a fragment of bone.
- The shaft of the metatarsal is commonly injured because of twisting of the foot on landing from a jump. This is a common problem in ballet dancers.
- This type of metatarsal fracture generally occurs due to repeated stress to the bone, which is also termed overuse.
- Are typically seen in those who have marched or run for long distances, especially if carrying heavy packs (which is why they used to be called ‘march fractures’).
- Often affect athletes and sportsmen, although they can affect any runners, even those who only run a little. They are commonly seen in the military during training exercises.
- They are common in runners who:
- Suddenly increase their running mileage or intensity.
- Run in poor footwear that doesn’t suit their feet:
- People’s choices and needs for running shoes vary. However, before choosing something unusual such as barefoot shoes or corrective shoes, make sure you take advice. For example, for barefoot running you need to be taught the right technique. Break in new running shoes gradually – many injuries result from a sudden change in running shoes.
- Have just changed their running shoes and not ‘broken them in’ carefully.
- Continue to exercise despite having foot pain.
- They are also frequently seen in ballet dancers and gymnasts.
- Abnormalities of the structure of the foot, and abnormalities of the bones and joints, such as rheumatoid arthritis or ‘thinning’ of the bones (osteoporosis), can make stress fractures more likely.
- They can also occur in people who have lost nerve sensation in their feet due to neurological problems – for example, diabetes that has affected the feet.
Does osteoporosis cause metatarsal fractures?
Metatarsal fractures (of both types) occur more easily if the metatarsal bones are weakened due to ‘thinning’ of the bones (osteoporosis).
See the separate leaflet called Osteoporosis for more detail.
Does ageing make metatarsal fractures more likely?
Most metatarsal fractures occur in younger people, as they are more likely to be involved in the kinds of sports and marching activities that make them more likely. However, as we become older the ‘springiness’ and padding of our feet tend to reduce. This means that our feet absorb impact less well and it is easier to fracture bones. Supportive footwear will make this much less likely.
See the separate leaflet called Ageing Feet for more detail.
What are the symptoms of a metatarsal fracture?
Acute metatarsal fracture
- May make an audible sound at the time of the break and you will usually have immediate pain and tenderness around the area of the fracture.
- The pain is often called ‘pinpoint pain’ as it is quite well localised at the site of impact to the bone.
- Broken bones bleed, so bruising and swelling can develop and you may have difficulty putting weight on the affected foot.
- Movement of your foot may also be limited. Surprisingly, however, pain can settle within a few hours.
People sometimes say that it isn’t possible to walk on a broken foot but this is not correct. Whether you can walk on a broken foot depends on which bone is broken (and whereabouts along its length), whether the fracture is displaced, how supportive your shoes are, and your personal tolerance to pain. It is, therefore, possible to walk on a broken foot, although it is likely to be very uncomfortable to do so and it may well make matters worse if you do.
- Similar symptoms to acute metatarsal fractures (above), although there is usually no bruising and no cracking sound.
- At first, the main symptom may just be pain in the foot during exercise that is relieved by rest. The pain tends to be widespread and diffuse in the foot.
- After a while, the pain may become continuous, so that it is not relieved by resting. The sore area tends to become more localised to the area of the fracture, and the pain gradually increases.
- Typically the stress fracture causes a tender area along the line of the second or third metatarsal bone.
- There may be some swelling but there is usually no bruising.
People who have stress fractures may continue to walk for some time. Eventually this becomes increasingly painful, as the splits in the bone tend to worsen and the bone itself starts to react and become inflamed, and it can become impossible to weight bear. A metatarsal stress fracture can progress to become a full-thickness fracture.
Will the pain increase?
Metatarsal stress fractures can begin as very small injuries which do not cause severe pain. However, if you carry on stressing the bone, the crack will often deepen and widen, becoming gradually more painful. Eventually, in the worst case scenario, the stress fracture may progress to become a full fracture.
If you have an acute fracture and you continue to stress the bone, the pain will increase further as the broken ends of bone will start to rub slightly against one another, and the area will become inflamed. In the worst case scenario the fracture may become displaced.
Do I need any investigations?
Your doctor is likely to suggest an X-ray of your foot if they suspect a metatarsal fracture.
Acute metatarsal fractures
- Most can be seen easily on X-ray. Initially doctors can see the crack in the bone, and after a few days they can also see irregularities in the bone as it starts to heal and remodel itself.
- Computerised tomography (CT) scanning or magnetic resonance imaging (MRI) scanning is occasionally needed.
- The doctors will need to determine if the fracture is displaced, which may mean that the bones need to be re-aligned and held in place. This is quite common in acute metatarsal fractures, as the weight of your body tends to push down on the broken bone and this can force the two broken ends slightly apart.
- Do not show up as easily on X-ray, particularly not at first. Half of them never show up on a normal X-ray.
- There can be multiple, very tiny fractures and splits in the bone, or just one fine crack which doesn’t go right through the bone. Because they have formed very gradually, the bone may not have ‘reacted’ very much to the injury.
- A specialised ultrasound scan may show a fracture that can’t be seen on X-ray.
- Metatarsal stress fractures can usually be seen by using a bone scan.
- MRI scanning is also sometimes used to find stress fractures.
Do I need to see a doctor if I suspect metatarsal fracture?
You should seek medical advice if you suspect that you have a metatarsal fracture. A doctor is able to do tests, including imaging, which will suggest the best course of action – not only to make things better as quickly as possible, but also to prevent making things worse.
How are metatarsal fractures treated?
This depends on:
- Which metatarsal bone is broken (fractured).
- Which part of the metatarsal bone is broken.
- How severe the damage is.
- Whether it is an acute fracture or a stress fracture.
It also depends on:
- Whether the fractured bone is displaced or non-displaced (see above).
- Whether the tissues of the foot around the break are also badly injured causing the fracture to be an open fracture.
The basic principles of treating metatarsal fractures are as follows.
Painkillers such as paracetamol and non-steroidal anti-inflammatory painkillers such as ibuprofen which may help to relieve pain.
Applying ice to your foot can also be helpful as pain relief. Ice should be applied as soon as possible after injury, for 10-30 minutes. (Less than 10 minutes has little effect. More than 30 minutes may damage the skin.) Make an ice pack by wrapping ice cubes in a plastic bag or towel, or by using a bag of frozen peas. Do not put ice directly next to skin, as it may cause ice burn. Gently press the ice pack on to the injured part. The cold is thought to reduce blood flow to the damaged area. This may limit pain, inflammation and bruising. Some doctors recommend re-applying for 15 minutes every two hours (during daytime) for the first 48-72 hours. Do not leave ice on while asleep.
See the separate leaflet called Heat and Ice Treatment for Pain for more details.
Rest and elevate
Elevation initially aims to limit and reduce any swelling. For example, keep the foot up on a chair to at least hip level when you are sitting. When you are in bed, put your foot on a pillow. Sometimes rest is the only treatment that is needed, even in traumatic fracture.
Stop stressing the foot
If you’ve been diagnosed with a stress fracture, avoiding the activity that caused it is important for healing. This may mean using crutches or even a wheelchair.
Some fractures just need support to help healing. For example, a supportive elastic tubular bandage with a supportive, rigid shoe or boot. If needed, special shoes are available to help to immobilise the fracture and support the foot so that you are able to walk. Progressive weight bearing on the foot can then follow as pain allows. Other fractures may need treatment with a below-the-knee plaster cast.
Very occasionally, surgery may be necessary – for example, to re-align any part of the bone that has moved out of position. Surgery is not needed for stress fractures.
Physiotherapy and a gradual return to exercise are a part of good follow-up care.
When can I return to activity after metatarsal fracture?
- Acute metatarsal fractures generally take around six to eight weeks to heal. However, it may be longer than this before a sportsperson is fully back in action.
- Stress fractures normally heal without any complications and, in time, people are able to return to their previous activities fully. You can return to your activities when you can perform them without pain. This will typically take six to twelve weeks. When you do start exercising again, you should gradually build up your activity levels. A sudden return to high-intensity exercise after a break may cause a repeat or a new stress fracture, or other injury.
What if the pain gets again worse?
If the pain gets worse then you should seek medical advice. The expected pattern of healing, in bony injuries of any kind, is that they should gradually hurt less as healing occurs, and that any gradual worsening of pain suggests that the injury is also getting worse, or that you have a fresh injury.
If your foot pain is increasing over time then your activity may be making an existing problem worse. In the case of a stress fracture this may mean progression to an acute fracture. In the case of an acute fracture it may be worsening displacement of the bones and preventing the two ends of the bone from knitting together. Always return to your doctor or health professional for further advice if you have gradually worsening symptoms.
What are the complications of metatarsal fractures?
If properly treated then metatarsal fractures should heal without long-term consequences. If not recognised and treated then some of these problems can occur:
- A metatarsal stress fracture can become gradually worse if repeated stress to the bone continues. It can eventually become a full-thickness metatarsal fracture.
- A fracture of the first metatarsal bone can lead to later arthritis of the big toe joint.
- A fracture at the base of the fifth metatarsal bone is often mistaken for an ankle sprain and therefore not rested or supported enough. This can lead to problems in healing and continuing pain.
- A full-thickness fracture which is displaced and not ‘put back’ into line can heal ‘out of shape’, leading to deformity of the foot, sometimes making shoe fitting difficult. The foot may be painful.
- Acute metatarsal fracture can also, occasionally, lead to ‘non-union’, which is when the two ends of broken bone stop trying to heal because movement between them makes this impossible. This may lead to reduced ability of the foot to cope with stresses and strains of walking and running and it may also lead to chronic pain in the foot.
Can metatarsal stress fractures be prevented?
There are a number of things that you can do to help prevent stress fractures:
- Exercise intensity and duration should be built up slowly and gradually.
- Rest time and recovery time need to be built in to any training schedule.
- Footwear should be well fitting and suit your running style. If changing – for example, from supportive training shoes to barefoot running shoes – you should be shown how to adapt your style. You should practise this gradually.
- You should be aware of the symptoms of stress fractures, and should not continue to run on a painful foot.
If stress fractures are recognised and treated quickly, this can reduce the amount of time that you need to stay away from activities.
Dangers of Bone Fractures if Left Untreated: Mid Atlantic Orthopedic Associates, LLP: Orthopedic Surgery
If you break a bone, it’s imperative that you get it treated. Regardless of where the fracture took place in the body, the stress of a broken bone can be quite substantial, which means that you have to act sooner rather than later.
For the most part, bones are exceptionally good at healing. Unlike other parts of the body, when they are treated correctly, you can make a full recovery and have a bone that is as good as new. However, if left untreated, the problem can get worse and lead to complications and more pain and suffering.
Nonunion vs. Delayed Union
When a bone fracture is untreated, it can result in either a nonunion or a delayed union. In the former case, the bone doesn’t heal at all, which means that it will remain broken. As a result, swelling, tenderness, and pain will continue to worsen over time.
Delayed unions are bone fractures that take longer to heal than usual. In most cases, though, patients can make a full recovery, although there can also be complications, depending on how well the bone was set.
How Do Bones Heal?
When there is a fracture, that means that the bones have separated. A partial fracture means that some of the bone is still connected, whereas a total fracture implies a complete split.
In most cases, the doctor will set the bone so that the two sides can connect and heal. New tissue grows, new bone material fills in the gap, and you’re back to normal.
To ensure that this process happens smoothly, these conditions have to be met.
Stability –if the bones are misaligned, then they will connect unevenly. If that happens, it could impact the structural integrity of the tissue and lead to more pain and suffering.
Blood Supply –your bones heal thanks to the components of your blood. Thus, it’s imperative that the tissue gets adequate blood supplied to the site to facilitate rapid healing.
Nutrients –we all know that calcium helps build strong bones, so it’s extra vital to consume the right nutrients when they are healing.
Complications of Bone Healing
In some cases, even with the right treatment, your bones may not heal properly. Some of the risk factors that can lead to complications include-
- Old age
- Tobacco use (smoking)
- Low vitamin D supply
- Some medications, including anti-inflammatories
Bottom Line –Stay Healthy and Get Treated
If you ever experience a bone fracture, it’s crucial that you seek medical attention as soon as possible. Once the bone is set, then you have to make sure that you’re helping your body heal as quickly as it can. If you have any of these risk factors, you want to talk to your doctor about how to mitigate them to facilitate faster healing.
Overall, a broken bone is a serious injury. Failing to get treatment can make things a lot worse.
In need of an orthopedic? Contact Mid Atlantic Orthopedic Associates today!
Shin fracture – Official website of the Federal State Budgetary Healthcare Institution KB No. 85 FMBA of Russia
About the tibia
Tibia (Latin os tibia) is a long, large, shin bone. Consists of a body and two articular ends. The proximal (upper end) of the tibia is involved in the formation of the knee joint. The distal (lower end) of the tibia, together with the fibula and talus, form the ankle joint.
Fracture of the tibia
Fracture of the tibia occurs due to the impact of a large force on the body of the bone, occurs at different levels.This happens more often in road traffic accidents. Of all the fractures of the bones of the musculoskeletal system, the fracture of the tibia accounts for 23% of the total number of injuries of the musculoskeletal system.
Classification of fractures of the tibia
Fractures of the shaft of the bone are classified into transverse, oblique, comminuted, fragmentary and intra-articular. Intra-articular tibial fractures include fractures of the tibial condyles and fractures of the medial (inner ankle).The inner (medial) malleolus is the medial bone stabilizer of the ankle; its fracture occurs during twisting (rotation) of the lower leg with a fixed foot. Also, a fracture of the inner (medial) ankle often occurs with a sharp, non-physiological turn of the foot.
Diagnosis of fractures of the tibia
Radiography is mainly used to diagnose a tibial fracture. In addition to radiography, our center for traumatology and orthopedics uses computed tomography with the function of three-dimensional image reconstruction.Modern methods of diagnosing bone fractures make it possible to correctly determine the tactics of treatment.
|Radiography of the tibia fracture||3D fracture reconstruction|
Complications of tibial fracture
Tibial fracture symptoms:
- deformation of the lower leg (change in the axis of the limb), due to displacement of bone fragments,
- pain on palpation and movements in this limb,
- impossibility to carry out axial load on this leg.
Treatment of tibial fractures
Currently, the treatment of tibial fracture , as a rule, is performed using surgery. Due to the anatomical structure of the tibia, tibia is located superficially along the main length (not covered by muscles along the medial surface), which often leads to secondary perforation of the skin with bone fragments in case of a fracture. Skeletal traction for the calcaneus is used in hospitals to immobilize bone fragments at fractures of the shin bones.This method is used for preoperative preparation and improvement of the skin condition on the injured lower leg.
In our center, traumatologists and orthopedists use the most modern methods of conservative and surgical treatment of tibial fractures. The use of the newest methods of extramedullary and intramedullary osteosynthesis allows to accelerate the recovery and rehabilitation of patients with fractures of the shin bones . As a rule, the patient can exercise the load on the injured leg the next day after the operation.In most cases, the use of osteosynthesis for intra-articular fractures in the early stages allows the articular surfaces to be restored as accurately as possible, which eliminates the risk of early development of arthrosis of the damaged joint.
90,000 Treatment of fractures, osteosynthesis operation: price – Moscow
Treatment of fractures in Moscow:
osteosynthesis operation in the clinic “MedicaMente”
On the basis of the clinic “MedicaMente” in Korolev (Moscow region.) modern high-tech methods of osteosynthesis are used in the treatment of bone fractures, allowing not only to return the patient to an active life as soon as possible (2-3 times faster than with old methods of surgery), but also to achieve a good cosmetic result. We carry out osteosynthesis treatment of fractures of the femoral neck, femur, lower leg, shoulder, forearm and hand, and we correct incorrectly fused fractures with this method.
How is the operation for a fracture using the osteosynthesis method
Modern technologies have made possible minimally invasive surgical access to the damaged area: fixators are installed through small (in most cases no more than 2-3 cm) incisions in the skin.All manipulations during the operation, osteosynthesis, traumatologists of the clinic “MedicaMente” are carried out under an electron-optical converter (EOP) in order to control the correct placement of the metal structure and accurate comparison of fragments. Accurate and stable fixation under X-ray control of an image intensifier eliminates the possibility of secondary displacement of fragments and the formation of incorrectly fused fractures.
The reduction achieved under the control of the image intensifier is preserved using fixing structures. For osteosynthesis, we use implants from the world’s leading manufacturers: we perform osteosynthesis with wires, pre-curved plates, intramedullary pins, which allow loading the operated segment within a few days after the operation.
The minimally invasive treatment of fractures under visual control using an image intensifier makes it possible to avoid cases of open reduction and skeletal traction, and to shorten the time of treatment and hospital stay. Minimal tissue trauma during surgical access to the damaged area and, as a result, minimal pain in the postoperative period, as well as, in fact, the absence of incisions in the skin are obvious advantages of modern methods of osteosynthesis used in Medicament.
Most osteosynthesis operations are performed under general anesthesia (anesthesia). Conductive or epidural (spinal) anesthesia may also be used. Before the operation, the anesthesiologist of the MedicaMente Medical Center will select the appropriate method of pain relief (depending on the patient’s condition and taking into account his wishes).
How to treat an incorrectly fused fracture
Treatment of incorrectly fused fractures is exclusively operative.Most often, the bones of the upper and lower extremities are operated on. The technical complexity of the operation largely depends on the time after the injury (the more time has passed, the more difficult it is) and the degree of existing limb deformity. Surgical treatment for fractures that do not heal properly with a slight functional impairment does not cause any particular difficulties. If during fusion the bone was deformed, and its fragments were displaced, more serious treatment is required (including the use of transosseous osteosynthesis techniques on the Ilizarov apparatus).
Clinic “MedicaMente” has extensive experience in the treatment of incorrectly fused fractures of the entire arsenal of methods of osteosynthesis: intraosseous, extraosseous, external transosseous, combined. After surgical treatment, a rehabilitation course is prescribed, which includes exercise therapy, physiotherapy and massage.
What we have to offer:
We carry out osteosynthesis treatment of fractures of the femoral neck, femur, lower leg, shoulder, forearm and hand, we correct fractures that have not healed together using this method.
Modern approach to fracture treatment
The use of minimally invasive osteosynthesis techniques in the treatment of fractures without exposing bone fragments and the fracture zone contributes to the early activation of the patient, allows to shorten the period of inpatient treatment. Usually the period of hospitalization in a hospital is 2-3 days. Carrying out manipulations under the control of an image intensifier makes it possible to reposition the fragments of the injured bone especially accurately with minimal tissue damage and a lower risk of postoperative complications.Stable osteosynthesis makes it possible in the postoperative period to do without additional plaster immobilization, which makes it possible to begin functional treatment from the first days after the operation and contributes to a faster and more complete restoration of the function of the injured limb.
Treatment as soon as possible
In the case when, based on the results of diagnostics, the patient is shown surgical treatment, our clinic is able to provide the operation of osteosynthesis in the shortest possible period – from several hours to 2 days (depending on the nature of the injury).The operating rooms of the MedicaMente medical center are equipped with all the necessary modern operating equipment. The clinic has a wide range of models and sizes for the treatment of fractures of the ankle, clavicle, lower leg, femoral neck, radius and humerus. The operating team of appropriate training (anesthesiologists-resuscitators, traumatologists, surgeons, resuscitation and operating nurses) is constantly ready to work … photo from the operating room
Experience of traumatologists in Moscow
Professional and talented surgeons work at MedicaMent.By contacting us, you can be sure that the operation will be performed by a doctor specializing in operative traumatology for at least 10 years. The latest equipment for diagnostics and operations, which our medical center is equipped with, helps surgeons perform complex manipulations as accurately as possible, without errors … Center doctors
Professional care and comfort
At the MedicaMente clinic, patients will receive proper care and a friendly attitude. Patients are accommodated in modern, comfortable wards.Caring medical staff at a high level provide professional treatment and continuous patient care. The department has an intensive care ward with everything necessary for emergency artificial ventilation and monitoring the patient’s condition … photo of the hospital wards
Osteosynthesis operation for ankle fracture
Ankle fracture is one of the most common fractures. Our doctors have extensive experience in treating ankle fractures of varying complexity.We carry out surgical treatment of ankle fracture using osteosynthesis. The operation allows you to avoid immobilization of the ankle joint and start restoring movements in it immediately after surgery.
Osteosynthesis operation for clavicle fracture
In recent years, traumatologists have increasingly recommended surgical treatment for clavicle fractures. Clavicle osteosynthesis allows you to speed up the patient’s return to his daily physical activity and reduce the risk of complications and unsatisfactory treatment results.In the clinic “MedicaMente” osteosynthesis of a clavicle fracture is performed with reconstructive plates, specially anatomically curved in the shape of the clavicle. The shape of the plate helps to achieve precise repositioning and relieve tension in the sternoclavicular and clavicular-acromial joints. A wide range of consumables in the clinic’s arsenal allows you to choose and install the plate that is right for your case.
Osteosynthesis operation in case of leg fracture
When carrying out surgical treatment of a leg fracture, we give preference to minimally invasive, less traumatic methods that allow faster healing of a leg fracture.Fragments are fixed using modern high-tech implants. After the operation, osteosynthesis does not require external immobilization (gypsum).
Osteosynthesis operation for fracture of the humerus
Most fractures of the humerus are treated conservatively by reduction under anesthesia, immobilization in a plaster cast, or reduction with subsequent retention of its results by traction. In closed fractures, osteosynthesis is used only in individual cases, if it is not possible to reposition or fix the fragments.To fix the fragments, rods, screws or plates are used.
Osteosynthesis operation for hip fracture
The vast majority of hip fractures are subject to surgical treatment. In case of ineffectiveness of the osteosynthesis (fixation of fragments of the femoral neck), the joint is replaced with an artificial one (often in the elderly). This operation is called hip arthroplasty.
Removal of wires, plates after MOS (metal osteosynthesis)
After the restoration and consolidation of the callus (after about 1 year), in most cases, it is necessary to remove the metal fixator (plates, wires, pins used to fix the fracture).This is a planned operation that can be performed in our clinic. Removal of hardware after osteosynthesis is a less traumatic intervention than primary surgery, and in most cases it is possible without long-term hospitalization. The operation to remove the MOS is usually performed under general anesthesia. Usually, no complications arise with the removal of structures. The incision is made along the old scar, followed by the imposition of a cosmetic suture. Stay in the hospital after surgery for 1-2 days.
90,000 Post-gypsum period: how to quickly recover from an injury in Novosibirsk
Any injury is a very unpleasant thing. It happens in a matter of seconds, and knocks out of the rut for weeks or even months. And even if the treatment went well, and the bones healed correctly, those who “broke” know that after removing the plaster the suffering does not end – the recovery period begins. Sometimes it takes even longer for a full recovery than the treatment took. And so I want to speed up this process! In order to return the atrophied muscles that were in the plaster to their previous shape and restore the functions of the limb in the optimal time frame, there is a special professional rehabilitation massage.
So that a person, having removed the plaster cast from his foot, jumped up and immediately ran, or with his recently grown hand, began to draw and write, as before, it happens very rarely. Or rather, it doesn’t happen at all. After the limb has been immobilized for a long time, its muscles atrophy, the mobility of the joints becomes limited, trophism is disturbed, and blood circulation worsens at the site of the fracture. Swelling, pain, difficulties with flexion and extension of the limb are constant companions of the post-gypsum period.
Therefore, in most cases, those who have suffered an injury need rehabilitation treatment (physiotherapy, exercise therapy, massage).
In the hands of a professional
Rehabilitation massage (not to be confused with the usual tonic massage) allows you to increase lymph and blood flow, which is especially important for injuries of the lower extremities, when it is necessary to reduce their swelling.
Unlike other types of massage, with the help of rehabilitation massage with the development, you can restore muscle tone, eliminate their spasm, reduce pain, or even prevent its appearance.
And the main thing is to develop joints after plaster cast and restore their motor function in the shortest possible time.Of course, provided that such a massage will be performed by a qualified and experienced specialist.
Massage and self-massage
To develop a joint, to restore elasticity to the ligaments, many can do it on their own. It would be, as they say, desire. But even with a strong desire, it is unlikely that it will be possible to recover quickly. Only a rehabilitation massage specialist knows exactly who, when and what load should be given in order not to harm the joint, and which techniques will most effectively cope with the problem in each specific case.
The specialist can begin massage sessions while the limb is still in a cast.
“Independent recovery from an injury is possible, but, as a rule, it takes much longer,” says a specialist in rehabilitation massage Maria Istifeeva. “Sometimes a patient takes six months or even a year to do this.
Patients who began to develop the joint on their own, having asked for help and having undergone one session of professional rehabilitation massage with the development, immediately notice a positive result: the limb begins to move much better, the pain subsides, the swelling decreases.
This happens because the patient’s recovery takes place in close cooperation with the doctor. The massage specialist has all the necessary information about the features of the injury, the amount of possible stress at different stages of rehabilitation, has the opportunity to draw up an individual massage scheme and, together with the doctor, track the dynamics of recovery. ”
After a course of massage, a specialist will definitely recommend a set of exercises for self-fulfillment at home, which will help you recover faster.
“Much also depends on the state of the ligamentous-muscular apparatus of a person, – notes Maria Istifeeva. – For example, children have more elastic ligaments, therefore, with proper treatment of trauma, the rehabilitation period passes faster than in most adults. The same can be said about people. who go in for sports and have good physical fitness. Generally 15 sessions are sufficient, in some cases 20 sessions are required, maximum 25 “.
The number of massage sessions and their duration are selected individually, depending on the patient’s age, the duration of limb immobilization and, of course, on the nature of the injury.
The main stages of rehabilitation massage:
- Stage 1: Drainage massage to reduce swelling is performed for 2-3 days.
- Stage 2: massage aimed at eliminating muscle spasm and improving blood circulation.
- Stage 3: impact on the ligaments to improve their elasticity, both through massage and through exercises.
At the CNMT, you can undergo rehabilitation after a fracture of the bones of the shoulder, forearm, fingers, fracture in the wrist and elbow joint, tearing of the rotator cuff, rupture of ligaments and muscles, after a fracture of the thigh, bones of the leg and foot.
Useful information about fractures of the bones of the foot
The entire foot with 26 bones can be divided into 3 sections: back, middle and front.
The posterior section consists of the two largest bones of the foot: the talus and calcaneus; the middle section includes the scaphoid, three wedge-shaped: the first, second, third and cuboid bone. Finally, the forefoot is formed by five metatarsal bones and 14 phalanges of the toes.
Fractures of the bones of the foot occupy a significant place among the injuries of the bones of the skeleton.According to the literature, they account for 17 to 20% of all skeletal fractures. The frequency of fractures of the foot bones is distributed as follows: phalanges – 74.3%, metatarsal bones – 21.5%, tarsus bones – 4.2%, of which a calcaneus fracture accounts for 1.8%. The metatarsal bones and phalanges of the fingers are most often injured (73%), the calcaneus is the second most frequently injured.
Fractures of the bones of the hindfoot
These are, first of all, fractures of the talus and calcaneus, which of the many bony formations of the foot are the most important for ensuring the support function of the limb.Plasticity and ease of gait is largely due to the correct anatomical architecture of the hindfoot. Any violation of the anatomical integrity of the talus and calcaneus, ligaments, the relationship between the articular surfaces of these and nearby bones leads to a complete or partial loss of the static-dynamic function of the foot.
Fractures of the talus. Unlike damage to other bones, they cause serious consequences. The talus, articulating with the articular surfaces of various bones, plays an extremely important role in the biomechanics of the ankle, talocalcaneal and talo-navicular joints.
There are fractures of the neck, head, body of the talus, its posterior process, combined fractures. Fractures of the talus occur mainly when falling from a height on straightened legs. Isolated fractures are rare, in most cases they are combined with compression fractures of the calcaneus and, less often, other bones of the foot: scaphoid, wedge-shaped, metatarsal.
Calcaneus fractures. A distinctive feature of them is the variety of types of fractures that are very different in nature, which makes it impossible to use the standard option for treatment.
As noted, the main cause of calcaneal fractures is a fall from a height on straightened legs (83%), in other cases (17%), fractures are due to direct impact or compression. In polytrauma, fractures of the calcaneus are most often accompanied by fractures of the ankles, metatarsal bones and spinal injuries. Fatigue fractures of the calcaneus also occur, especially in recruits and recreational sports. Unfavorable outcomes in fractures of the calcaneus are mainly due to the formation of traumatic flat feet, valgus deformity of the foot, the development of deforming arthrosis in the subtalar joint and, to a lesser extent, osteoporosis, trophic disorders and fibrotic changes in the soft tissues of the foot and calcaneal region.
Calcaneus fractures are characterized by pain in the area of injury and the impossibility of loading the foot. Attention is drawn to the hallux valgus and varus deformity of the heel, expansion of the heel area, foot swelling, the presence of characteristic bruises in the heel area and on the plantar surface of the foot. The arches of the foot are flattened. Active movements in the ankle joint due to soft tissue edema and heel tendon tension are sharply limited, and in the subtalar joint are impossible.
In the event of a fall from a height with a landing on the heel tubercles, combined injuries of the calcaneus and spine are possible.Therefore, it is recommended to conduct an X-ray examination even if there are no complaints in the first days after the injury.
Treatment at the first stage is carried out by a traumatologist. Later, the participation of a rehabilitation physician is required to conduct a full course of rehabilitation treatment
Fatigue (stress) fracture: symptoms, prevention, treatment
A fatigue or stress fracture is an injury that instills fear in the heart of every runner, because of it you can permanently, and in neglected cases, and leave running forever.What is this injury, and how can it be treated or avoided? Everything you need to know about it, we will tell you in this material.
What is a fatigue fracture
Let’s say you run a lot and do not recover well. Over time, tired muscles will no longer be able to absorb the shock load and transfer it to the bones. Repetitive stress causes micro-damage to the bone, and if you add to this neglect of recovery, ignoring the symptoms of injury, then gradually these damage will become more and more noticeable.What happens next is called a stress fracture.
According to orthopedic surgeons, the second and third metatarsal bones of the foot are more susceptible to stress fracture than other bones. The area where they are located is most involved in running. She is responsible for repulsion.
Read on: Inflammation of the periosteum: how to treat and how not to get
Scope of trauma
Stress fractures can affect the heel, the ankle, the midfoot, and even the pelvis, the sacrum: in general, all those areas that are subject to impacts, and the muscles cannot absorb them due to fatigue.But in runners, the bones of the lower leg or foot are most often affected, because they are the most working ones for this sport. These are the supporting bones – the tibia and metatarsal.
Stress fractures of the leg and foot are successfully treated, and if the fracture occurs on very strong bones of the pelvis or hip, this indicates health problems that are much more serious than a sharp increase in load and insufficient recovery.
Symptoms and Diagnosis
Most common symptoms of fatigue fracture:
- Pain while running, walking and even at rest.If you experience pain while running that forces you to land on your foot differently than usual to avoid pain, see your doctor.
- Sharp pain when pressing on the area where discomfort is felt.
- Swelling in the affected area, but most often it occurs in the upper part of the foot. So, for example, you may have a more visible outline of the veins on your injured leg compared to the other foot.
To diagnose an injury, there is also a jump test: you need to jump several times on a leg that hurts, and if pain is felt when landing, this may indicate a fracture.
Training plans for marathon and half marathon. Download and start preparing today.
Good news: the bone has a certain margin of safety. This means that pain, hinting at a stress fracture, appears long before it. The measures taken in time will allow not to fall out of the running program for one and a half to two months.
Leading to stress fracture
In simple terms, insufficient recovery leads to this injury.Everyone has heard about the golden rule of 10% increase in training loads? All this is not easy, since both muscles and bones must get used to the load in order to be able to digest it. And it’s not just the mileage on your watch.
Fatigue fractures, as a rule, are the result of not only an unusually large volume, but also a sharp increase in intensity, when the body does not have enough time to adapt. In this case, the bone will simply exhaust all its resources for recovery.
Winter is the period when the risk of developing a stress fracture is greatest.Reason: Lack of vitamin D. So remember that you, as an active person, need higher levels of vitamin D than everyone else.
What else could put a runner at risk? Low calcium levels, coupled with high caffeine consumption, flushing it out of the body. In addition, studies show that women with a low body mass index and older runners are at a particular risk group and tend to lose bone density over the years.
Influence of running technique
Running on the heel often leads to a stress fracture, according to world statistics.This positioning of the foot puts more stress on the thigh, increasing the likelihood of injury to the tibia. However, running from the forefoot is “not without sin.” For untrained feet, it carries the risk of a fatigue fracture of the foot and ankle bones.
You should also pay attention to the surface. Suppose you have been running along unpaved paths all the time and in the winter you have moved to the arena, keeping the same volumes. A sudden change of surface is fraught with danger, especially considering that the track in the arena involves bends, and the asphalt, for example, is much harder than natural soil.
Read on: Where better to run: 9 running surfaces and their features
Influence of sneakers
Shoes that are out of size, not your pronation, or that cause general discomfort contribute to the likelihood of injury. And if the sneakers are perfectly matched to you, but have already lost their shock-absorbing ability from old age, this will also negatively affect the legs. Most manufacturers set the lifespan of their shoes at 800 km.
- Slowly increase the load and gradually make changes to the program.Experts recommend increasing the volume by no more than 10 percent from week to week.
- Work your cadence upwards: 80-90 strides per minute for one leg reduces the risk of injury.
- Do not do too much speed and tempo work. Run really light on light days;
- Include exercises to strengthen weak areas in the program. The key muscles are the calf and tibialis anterior.
- If possible, see a professional who will evaluate your running technique.
- Vary your running surface.
- Eat a healthy diet with enough calcium and vitamin D in your diet. Take vitamin and mineral supplements for bone health.
- Give yourself some recovery days after a tough session. Yes, you may feel full of energy, but the musculoskeletal system takes much longer to recover than the cardiovascular system.
Treatment and rehabilitation
It is most reasonable to make an appointment with an orthopedist after the first pains.If it is impossible to do this right away, help yourself: stop running, apply ice 3-4 times a day for 10 minutes, take painkillers.
At the doctor’s appointment, you will be prescribed an examination. This is likely to be a CT scan or magnetic resonance imaging scan, since X-rays cannot detect a fracture at an early stage.
Upon confirmation of injury, you will be banned from activity, and a plaster cast will be applied to the damaged area to support the bone while it heals.During this period, your main remedy is rest. Within 6-8 weeks, you should completely abandon the activity that caused the injury and replace it with an activity that does not have a negative effect on the injury. For example, you can spin your bike or go skiing, roller skiing or rollerblading. Talk to your doctor for advice on safe exercise.
How to replace running: 13 training alternatives
photo: Zoff-Photo / Getty Images, source: runnersworld.com
If jogging is resumed before it is completely healed, it can cause a much larger fracture, which will make the bone problems chronic. Do not bring your injury to surgery or, even worse, to a complete bone fracture. Just imagine that treatment and rehabilitation in this case will take at least six months.
It should also be borne in mind that once a stress fracture occurs, there is an additional risk for re-injury. This is a hint to take care of your body in the future.
Stress fractures are treated not only with complete rest and bone plaster support. You may be assigned:
- medical gymnastics;
- manual therapy;
How to get back to running and training
So, after 8 weeks off your running shock, your muscles and bones have recovered. How to train? Of course, forget about the previous volumes and do not try to update all your personal records.Exercise should be resumed gradually and stopped if you feel pain. Ignoring these simple guidelines increases the likelihood of re-fracture.
During the gradual return to training, wear compression gaiters, a brace, or an ankle boot, depending on the location of the injury. They will take stress off the weakened area. Buy special inserts or orthopedic insoles for your shoes for better shock absorption.
Read More: 9 Simple Exercises to Strengthen Your Feet
90,000 Types of fractures
Fracture – partial or complete violation of the integrity of the bone.Most often, fractures occur when the bone is suddenly exposed to significant mechanical force, when the skeletal system is not changed. These fractures are called mechanical (traumatic) fractures. The integrity and continuity of the bone can also be disturbed by a pathological process developing in it. Such a fracture is called pathological (spontaneous). It can occur without any external influence or it can be very insignificant.
Violation of the integrity of the bone under the action of mechanical force is always accompanied by damage to soft tissues.The degree of damage to the latter, as well as the nature of the fracture, largely depends on the strength of the mechanical effect. Violation of the integrity of the bone, when the connection between its parts is not broken, is usually called a crack (fissura).
Fractures are quite common in clinical practice. So, according to the Institute of Emergency Medicine. Sklifosovsky Research Institute for Emergency Medicine in Moscow, fractures of various bones were detected in 33.2% of cases, i.e., almost every third patient admitted with an injury had a bone fracture.In this case, fractures were most often localized in the bones of the extremities (61.2%). According to the statistics of polyclinic departments, a significant place among bone fractures is occupied by fractures of the bones of the foot and hand (62.5%).
Most cases of fractures occur between the ages of 20 and 40 in men. The frequency of certain types of fractures is closely related to certain seasons. For example, spinal fractures are more common in summer during the swimming season, and ankle fractures and epiphyseal bone fractures are more common in winter when falls on icy roads.Lower limb fractures.
Classification of fractures:
Depending on whether the bone wound communicates with the external environment through damaged body tissues or not, all fractures should be divided into closed and open. This division of fractures is fundamentally very important, because with open fractures, there is always a danger of pathogenic microorganisms entering the wound and the development of a purulent or putrefactive inflammatory process in the fracture zone.This must always be taken into account when providing first aid to a victim with a fracture, and even more so when treating fractures.
By localization, fractures are divided into diaphyseal, metaphyseal and epiphyseal .
Epiphyseal (intra-articular) fractures are the most severe.
With them, the configuration of the joint is sharply disrupted and very often there remains a persistent violation of movements in it.In some cases (especially in children) there is a separation of the epiphysis, the so-called epiphysiolysis, which is more often observed in the area of the epiphysis of the humerus, radius and tibia.
Metaphyseal (periarticular fractures) are often fixed due to the adhesion of one bone fragment to another. Otherwise, they are called impacted. The periosteum is often not damaged in these fractures. Therefore, such fractures often have the character of cracks in the form of longitudinal, radiant and spiral lines.
In clinical practice, diaphyseal fractures are more common.
Taking into account the mechanism of fracture formation, it is customary to separate fractures from axial compression, from flexion, from twisting. The mechanism of various types of bone fractures is based on the laws of mechanics, according to which molecules, under the influence of trauma, either approach each other (compression, compression fractures), or move away from each other (avulsion fractures).Or, finally, they move in relation to each other as in a helical thread (spiral, helical fractures). The degree of bone destruction depends on the duration of exposure to the bone of an external traumatic factor and the direction of the force of this factor.
Compression or compression fractures can occur both longitudinally and transversely to the axis of the bone. Long tubular bones are more often damaged when pressed in the transverse direction than in the longitudinal one.Compression of these bones in the longitudinal direction leads to the formation of impacted fractures. Often, compression fractures are localized in the spine, the vertebral bodies of which are, as it were, flattened.
Flexion fractures occur from direct and indirect violence. The bone bends to the limit of its elasticity and breaks. In this case, on the convex side of the bone, a rupture of its surface parts occurs, a number of cracks extending in different directions are formed. The bone breaks, sometimes forming a triangular splinter.
Fractures from twisting along the longitudinal axis of the bone are called torsional, spiral, or helical. These fractures are localized in the large tubular bones (thigh, shoulder, tibia). The fracture is usually located away from the point of application of the force.
Avulsion fractures occur as a result of a sharp muscle contraction that occurs suddenly. In this case, sections of the bone are torn off, to which the sharply contracted muscle is attached.
Depending on the degree of violation of the integrity of the bone, fractures are usually divided into complete and incomplete (cracks). With a complete fracture, the bone is damaged along the entire length of its tissue, which allows the bone fragments to move in relation to each other (displaced fractures). With incomplete fractures, the displacement of bone fragments does not occur (fractures without displacement). A typical example of an incomplete fracture is a subperiosteal fracture that occurs in children under 15 years of age.
In the direction of the bone fracture line, it is customary to talk about transverse fractures (the fracture line is located perpendicular to the axis of the bone), longitudinal (the fracture line goes along the axis of the bone). Oblique (the fracture line is directed to the axis of the bone at an angle), helical or spiral (twisting of bone fragments along its axis). The reasons that lead to the displacement of bone fragments during bone fracture can be divided into three types: 1) primary displacement arising from the action of physical force and the direction of its action; 2) secondary displacement due to the contraction of the muscles that attach to the broken bone; 3) tertiary displacement resulting from the action of secondary external mechanisms on the damaged bone (improper transportation from the site of injury, restless behavior of the patient).When the bone fragments are displaced, muscles, tendons, and nerves can wedge between them, which significantly complicates the course of the fracture and affects its treatment (interposition fractures). Depending on the number of damaged areas of the bone, it is customary to distinguish between single and multiple bone fractures.
Multiple fractures are also talked about in cases where the victim has several broken bones.
If during a bone fracture, damage to the organs located in the area of the fracture occurs, then such fractures are called complicated.If a fracture is not accompanied by damage to organs, then it is called simple, however, it should be noted that in fact there are no simple fractures, since a fracture always involves damage to soft tissues in the area of its location. But since these tissue injuries do not require special treatment, these fractures are considered uncomplicated.
Complicated are fractures of the skull bones with damage to the brain tissue, fractures of the pelvic bones with damage to the pelvic organs, open fractures, bone fractures with damage to large vessels and nerves.
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Details of Biden’s leg fracture became known
President-elect of the United States was injured while playing with a dog
US President-elect Joe Biden broke his leg while playing with a dog. While bone fractures in old age raise concerns, the 78-year-old looks to get off easy.
The president-elect is limping, although he does not need crutches or assistive devices, Sky News reports. Joe Biden sustained the injury while playing with one of his dogs, his doctor said.
Biden visited a podiatrist in Newark, Delaware on Sunday afternoon after suffering an injury the day before. Biden’s office initially announced that the politician was going to be examined by a podiatrist “as a precaution” after he sprained his ankle while playing with a dog.
Initial X-ray showed no obvious fractures, but more detailed CT scans were ordered by the medical staff. Biden’s CT scan revealed tiny fractures of two small bones in the middle of his right foot, his physician Kevin O’Connor said.
“It is expected that he will probably need special shoes to heal his foot after a fracture within a few weeks,” O’Connor added.
A surprise against this background was the wish of Donald Trump, who tweeted to his opponent: “Get well soon.”
Joe Biden was seen limping as he left the doctor’s office for a CT scan without using a crutch or other walking device.
Wearing a mask and casual clothes, he seemed to be in good spirits as he waved to the assembled reporters.
The President-elect was playing with his dog Major when he was injured. The Major was recruited from the orphanage in 2018 and is expected to move into the White House with his master next January.
The Biden family has another dog, Champ (also a German shepherd, CNN reports), and they said they plan to have a cat as well.
Fractures are usually of concern in the elderly, but Biden’s case appears to be relatively mild, judging by his doctor’s statement and planned treatment. Recall that 78-year-old Joe Biden will become the oldest president of the United States at the time of his inauguration in January, although he often brushes off questions about his age.Last December, he published a medical report that said the politician took statins to keep cholesterol levels normal, but his doctor described Biden as “healthy, energetic” and “capable of successfully serving as president.”
In the recent past, prominent American politicians have at times also faced injuries of varying severity.
In 1997, Democratic President Bill Clinton injured his leg while walking down the steps of professional golfer Greg Norman’s estate in Florida.The American leader on the same day had to undergo a two-hour operation at a naval hospital in the suburbs of Washington to repair a torn tendon in his right knee.
And in 2004, Republican President George W. Bush fell off a mountain bike while riding on his ranch in Crawford, Texas. The head of state escaped with abrasions and scratches on his chin, upper lip, nose, right arm and knees.