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Fracture of Foot
Fractures to the metatarsal bones can be caused by direct trauma, excessive rotational forces or overuse.
There are five metatarsals in the foot. The first metatarsal is the most important and fractures of the first metatarsal usually require surgery. Fractures of the middle metatarsals (the second, third and fourth) do not require surgery unless there are significant displacements of the bone.
Causes
Injuries to the metatarsals are sustained in many different ways such as:
- Minor twists
- Falls and
- Injuries sustained from heavy objects fall on the foot
Overuse
This can lead to stress fractures of the metatarsals.
These fractures are common in army recruits as well as sporting individuals and are commonly known as 'march' fractures.
The patient will normally report about two weeks of gradually increasing pain in the region before an incident 'converts' the stress fracture to a full fracture. The second metatarsal is the most commonly affected, but the fifth metatarsal can also be affected.
Types of fracture
The Jones fracture
This occurs to the fifth metatarsal. It refers to a transverse fracture through the metatarsal and an Avulsion fracture is when a muscle (contracting to prevent a sprained ankle) pulls so forcefully that it pulls off a piece of the metatarsal bone.
Rotational forces fractures
Such fractures occur when the ankle twists and the player makes an attempt to stop himself going over on the ankle. This mechanism of injury usually affects the fifth (outermost) metatarsal. Therefore, it is not uncommon for ankle sprain injuries to be accompanied by a fracture to the fifth metatarsal.
Direct trauma
The injury is usually caused by a player accidentally kicking the sole of an opponent's boot, or by an opponent stepping on a player's foot. As there is very little soft tissue to protect the top of the foot, bony injuries are common. The second, third and fourth metatarsals are the most commonly fractured with this mechanism of injury.