bubble_chart Overview

Metatarsal bones and toe fractures are common fractures, often caused by heavy objects striking the dorsum of the foot, crushing, foot inversion sprains, or accidentally kicking hard objects.

bubble_chart Treatment Measures

1. Avulsion fracture of the base of the fifth metatarsal bone

The peroneus brevis muscle attaches to the tuberosity at the base of the fifth metatarsal bone. Severe inversion sprain of the foot can cause a fissure fracture or complete avulsion fracture. Care should be taken to distinguish it from the normal epiphysis in children during X-ray examination.

Treatment: Generally, if there is no displacement, adhesive tape fixation and bandage wrapping can be used. If necessary, a gypsum boot (with a rubber heel for walking) can be applied for approximately 6 weeks. Other non-displaced fractures of the metatarsal base can be treated similarly.

2. For displaced fractures of the necks of the 2nd, 3rd, and 4th metatarsal bones, manual reduction and short-leg gypsum fixation should be performed. Otherwise, malunion may affect walking. If reduction is unsuccessful, surgical reduction with pin fixation may be necessary.

3. March fractures are relatively rare and occur after long-distance walking, typically involving the necks or shafts of the 2nd and 3rd metatarsal bones, though they can also occur in the tibia. Generally, there is no displacement, hence the term "fatigue fracture." These fractures often occur unconsciously, with no history of trauma. Symptoms are mild, with only slight early pain in the affected foot, localized grade I swelling, and a feeling of fatigue or discomfort in the foot. Sometimes, the fracture is only discovered after significant callus formation.

Treatment: Adequate rest is recommended. Early use of arch support, adhesive tape fixation, or gypsum immobilization for about 3 weeks can prevent excessive callus formation. Later, arch supports (transverse and longitudinal) can be used to distribute weight until symptoms disappear. There are no long-term complications after healing.

For toe fractures, if there is an open wound, it should be cleaned to prevent infection. If there is no displacement, local bandaging and fixation are sufficient. If displacement occurs, manual reduction should be performed, fixing the affected toe in a flexed position.