Toe and Forefoot Fractures
Bone fractures of the toes and forefoot are certainly quite prevalent for individuals in the Mexico, MO area. Fractures may arise from a direct impact to the foot-- like unexpectedly kicking something hard or dropping a hefty object on your toes. They may also arise from the overuse and repetitive stress that comes with taking part in high-impact sports such as running and basketball.
Even though fracturing a bone in your toe or forefoot can be very painful-- it almost never requires surgery. For the most parts, a fracture will heal with rest and a change in activities.
Anatomy
The forefoot has 5 metatarsal bone tissues and 14 phalanges (toe bones). There are 3 phalanges in every toe-- except for the first toe, which generally has just 2.
All the bones in the forefoot are designed to work together whenever you walk. A fracture, or break, in any one of these bones could be painful and impact how your foot functions.
Description
Toe and forefoot fractures frequently arise from trauma or direct injury to the bone. Fractures may also develop after repetitive activity, as opposed to a singular injury. This is called a "stress fracture."
Fractures might either be "non-displaced," where the bone is cracked but the tips of the bone are together, or "displaced," where the tip of the broken bones have partially or fully separated.
Fractures can also be split into "closed fractures" where the skin is not broken and "open fractures" where the skin is damaged and the wound extends to the bone.
Open fractures are especially severe since, once the skin is broken, bacteria can enter the wound and cause infection in the bone. Quick treatment is needed to prevent infection.
Symptoms
The absolute most common symptoms of a fracture are pain and swelling. Other symptoms may include:
- Bruising or discoloration that reaches nearby parts of the foot
- Pain with walking and weight bearing
First Aid
If ever you think you have a fracture, it is important to see your physician as soon as possible. A fracture that is not treated can lead to persistent foot pain and joint inflammation and influence your ability to walk.
Whilst you are waiting to see your doctor, you ought to do the following:
- Apply ice in order to help decrease swelling.
- Elevate your foot as much as possible.
- Reduce weight bearing.
- Lightly wrap your foot in a soft compressive dressing.
Doctor Examination
Physical Examination
When you see your physician, he or she will take a history to find out how your foot was hurt and inquire about your symptoms. Your doctor will then examine your foot and might compare it to the foot on the contrary side.
In the course of the examination, they will look for:
- Inflammation
- Tenderness over the fracture site
- Bruising or discoloration-- your foot may be red or ecchymotic (" black and blue").
- Deformity.
- Skin abrasions or exposed wounds.
- Loss of sensation-- an indication of nerve injury.
Imaging Studies
Your doctor will also order imaging studies to help diagnose the fracture.
X-rays. X-rays provide images of dense structures, like bone. An x-ray can usually be carried out in your Mexico, Missouri doctor's office.
The majority of fractures may be seen on a routine ordinary x-ray. A stress fracture, however, might start as a little crack in the bone and might not be visible on a first x-ray.
Oftentimes, a stress fracture can not be seen until a number of weeks later when it has actually started to heal and a kind of healing bone called "callus" shows up around the fracture site.
Magnetic Resonance Imaging (MRI) scans. If your doctor suspects a stress fracture but can not check it out on a plain x-ray, they may recommend an MRI scan. This type of study utilizes a magnetic field and radio waves to produce a computerized picture of your foot.
More sensitive than an x-ray, an MRI can easily spot changes in the bone that might indicate a fracture. Unlike an x-ray, there is no radiation with an MRI. The study takes 40 minutes to do, however, and must be scheduled separately from your doctor's visit.
Treatment
Treatment for a toe or forefoot fracture depends upon:
- The location of the injury.
- The kind of fracture.
Fractures of the Toes
Even though toes are remarkably small, injuries to the toes can frequently be rather painful.
A fracture of the toe might result from a direct injury, like dropping a heavy object on the front of your foot, or from unintentionally kicking or running into a hard object. A fracture might also come about if you inadvertently hit the side of your foot on a piece of furniture on the ground-- and your toes are turned or pulled sideways or in an uncomfortable direction.
The proximal phalanx is the toe bone that is nearest to the metatarsals. Since it is the longest of the toe bones, it is the most likely to fracture.
A fractured toe might become swollen, tender and discolored. If the bone is out of place, your toe will seem deformed.
Treatment
Most broken toes may be treated symptomatically. For several days it could be painful to bear weight on your injured toe. As your pain subsides, however, you can start to bear weight as you are comfortable. Throughout this time, it might be helpful to wear a wider than usual shoe.
"Buddy taping" your broken toe to an adjacent toe may also sometimes help relieve pain.
If the bone tissue is out of place and your toe seems deformed, it might be necessary for your doctor to manipulate or "reduce" the fracture. This procedure is usually completeded in the doctor's office. You will be given a local anesthetic to numb your foot, then your physician will manipulate the fracture back into place and correct your toe.
Metatarsal Fractures
The metatarsals are the lengthy bones in between your toes and the middle of your foot. Every metatarsal has the following four parts:.
- Head-- which makes a joint with the base of the toe.
- Neck-- the slim area between the head and the shaft.
- Shaft-- the lengthy piece of the bone.
- Base-- which makes a joint with the midfoot.
Fractures can occur in any portion of the metatarsal, but most frequently occur in the neck or shaft of the bone.
Like toe fractures, metatarsal fractures may come from either a direct impact to the forefoot or from a twisting injury.
Some metatarsal fractures are stress fractures. Stress fractures are little cracks within the surface of the bone that might extend and become larger with time.
Stress fractures are usually caused by recurring activity or pressure on the forefoot. They are prevalent in runners and athletes who take part in high-impact sports like soccer and basketball.
A stress fracture may also arise from a sudden increase in physical activity or an alteration in your exercise regimen.
Treatment
Most metatarsal fractures can be treated with an initial period of elevation and limited weight bearing. This is followed by progressive weight bearing, as tolerated, in a cast or walking boot. Surgery is rarely called for.
However, if you have fractured a number of metatarsals at the same time and your foot is deformed or unstable, surgery is required.
During the procedure, your physician will make an incision in your foot, then insert pins or plates and screws to keep the bones in place while they recover. This is called "internal fixation.".
Surgery may be postponed for several days to allow the swelling in your foot to go down. If you have an exposed fracture, however, your physician will perform surgery immediately.
Fifth Metatarsal Fractures
The fifth metatarsal is the long bone on the outside of your foot. Injuries to this bone tissue might be different than fractures of the initial four metatarsals.
Most commonly, the fifth metatarsal fractures through the base of the bone. This usually occurs from an injury where the foot and ankle are coiled downward and inward.
In this specific sort of injury, the tendon that affixes to the base of the fifth metatarsal may stretch and pull a fragment of bone away from the base. Since the fragment is pulled away from the remainder of the bone, this type of injury is referred to as an "avulsion fracture.".
An avulsion fracture is also often called a "ballerina fracture" or "dancer's fracture" because of the "pointe" position that ballet dancers assume when they are up on their toes.
Another sort of fifth metatarsal fracture is a horizontal or transverse fracture through the junction of the base and shaft of the bone. This is often termed a "Jones fracture." Since the blood supply to this region is substandard, Jones fractures are much more prone to troubles in healing.
Treatment
Most fifth metatarsal fractures can be treated with weight bearing as comfortable in a walking boot. If an avulsion fracture results in a big displaced fracture fragment, however, open reduction and internal fixation with plates and screws may be necessary.
As a result of its location on the bone, a Jones fracture may take much longer to heal. In certain cases, a Jones fracture may not heal at all, a condition called "nonunion." Whenever this happens, surgery is typically required to treat the fracture.
Recovery
Healing of a broken toe may take from 4 to 8 full weeks.
Metatarsal fractures normally heal in 6 to 8 weeks, but might take longer. Your doctor will require follow-up x-rays to make certain that the bone is properly aligned and healing. Even with proper healing, your foot might be swollen for several months and it might be hard to find a comfortable shoe.
Your doctor will tell you when it is safe to return to activities and resume sports. If you experience any pain, nevertheless, you ought to stop your activity and tell your physician. Returning to activities prematurely may put you at risk for re-injury.
Undeniably, toe and forefoot fractures are an issue facing lots of orthopedic patients in Mexico, MO, as well as the encompassing communities of Fulton, Centralia, Vandalia, and Columbia.