Metatarsal Fracture

A metatarsal fracture is a break to one of the five long metatarsal bones in the foot and is usually caused by a direct impact or trauma.

Metatarsal fracture symptoms

Symptoms of a metatarsal fracture include acute severe foot pain at the time of injury. There will likely be rapid swelling and the athlete will be unable to weight bear. A visible deformity in the foot may be noticed and bruising will usually develop within 24 hours.

Acute metatarsal fractures

Metatarsals are the long bones in the forefoot. There are five in each foot, one leading up to each toe and forming the metatarso-phalangeal joints otherwise known as the MTP joints. Metatarsal fractures can be either an acute fracture or a stress fracture. A stress fracture is a more gradual onset of pain caused by overuse.

An acute metatarsal fracture is caused by a direct impact such as having the foot trodden on by a football stud or similar. Often something is dropped on the foot or the foot might be stamped on. Alternatively, a violent twisting or turning motion at the ankle may cause a fracture in the 5th metatarsal in particular.

Specific types of metatarsal fracture include an avulsion fracture, where the tendon of the peroneus brevis muscle pulls a piece of the bone away. Or a Jones fracture which occurs at the base of the 5th metatarsal. This area typically has a poor blood supply and so healing may be affected.

Treatment of a metatarsal fracture

See a Doctor as soon as possible who will most likely X-rays the foot to confirm whether there is a fracture and the type of fracture. If the bones are not displaced then a short cast or boot will be fitted for the first three weeks. After six weeks the foot should be X-rayed again to ensure it has healed.

More complex or displaced fractures may require surgical fixation. Jones fractures require 6-8 weeks of non-weight bearing immobilization. Once the cast has been removed, a thorough rehabilitation programme should begin to regain full mobility and strength. A gradual return to sport can then begin.