How to treat metatarsal fractures

How are metatarsal fractures treated?

First, how to treat metatarsal fractures? According to the displacement and reduction of the fracture, the appropriate treatment measures should be selected. For those without displacement and satisfactory reduction, the affected limb should be fixed with calf plaster or short boot plaster for 4 to 6 weeks after injury or reduction. For those with displaced fractures and plantar flexion of metatarsal heads: open reduction is feasible. If the local insertion is stable, only plaster external fixation is used; if it is still unstable after aligning, Kirschner wires should be used for cross fixation, which should be removed after 7 to 10 days and then replaced with calf plaster for immobilization.

Metatarsal shaft fracture: General displacement does not require surgery, but severe dislocation, especially those affecting the arch of the foot, requires open reduction, and then depending on the shape of the fracture line, steel wire, Kirschner wire or screw fixation can be selected. Fracture of the base of the fifth metatarsal: Only a very small number of patients require open reduction and internal fixation with small screws or Kirschner wires, etc., and plaster immobilization is still required after surgery. Marching fracture: Those with mild symptoms can be fixed with elastic bandages and rest for 3 to 4 weeks. Those with obvious fracture lines need plaster fixation.

Second, avulsion fractures of the metatarsal base are generally non-displaced.

1. It can be fixed with adhesive tape, bandaged, and if necessary, fixed with a plaster boot with rubber heel for walking for about 6 weeks. Other metatarsal base fractures without displacement can also be treated with the same method.

2. If the 2nd, 3rd, and 4th metatarsal neck fractures are displaced, they should be manually reduced and fixed with a short leg plaster, otherwise the deformed connection will affect walking. If the reduction is unsuccessful, surgical reduction and fixation with steel pins can be performed.

3. Marching fractures are less common and occur during long-distance walking. They occur at the 2nd and 3rd metatarsal necks or metatarsal shafts, and can also occur at the tibia. Generally, there is no displacement, and it is also called fatigue fracture. Proper rest is required. In the early stage, arch support, adhesive tape fixation or plaster fixation for about 3 weeks can prevent excessive callus formation. Later, arch pads can be used to disperse gravity until the symptoms disappear. There will be no sequelae after healing. If there is a wound on a toe fracture, the wound should be cleaned to prevent infection. If there is no displacement, local bandage fixation should be performed. If there is displacement, manual reduction should be performed to fix the affected toe in a flexed position.