Classification | Midfoot fracture

Classification

Since therapy is highly dependent on the extent of the injury, a classification is first made, which leads to corresponding therapeutic approaches. First of all, it is particularly important to determine whether there is soft tissue involvement, whether the fracture is stable or unstable, and where the fracture is located exactly. With regard to soft tissue involvement, a distinction is made between closed and open fractures.

In addition, the compartment syndrome should be distinguished from these, since this is a nerve involvement. The stability of the fracture depends on the number of metatarsal bones involved. A distinction is made between singular fractures, serial fractures and dislocation fractures. The fracture itself can be located at the base, shaft, subcapital and head.

Healing/Duration

The individual course of the disease and thus the time it takes for a metatarsal fracture to heal is influenced by various factors. The type of fracture, the age of the person affected, the presence of other damaged structures of the foot as well as the individually applied therapeutic procedure are particularly relevant. Experience has shown that older patients have to struggle with a fracture of the metatarsal bone for much longer.

If, in addition to the broken metatarsal bone, damage to joints or wounds has occurred or there are several fractures, this typically has an unfavorable effect on the healing process. Even fractures that can only be treated by surgery usually have a longer healing process. Fractures, for example, which have been caused by an enormous blunt force and result in a so-called comminuted fracture with a large number of bone fragments, heal only slowly after the operation.

The blood supply to the bone is essential for the healing process after a fracture. Thus, the individual vascular course and the location of the fracture also determine the duration and therapy of the disease. Bones are structures that heal relatively slowly.

In many cases, however, the foot can be loaded even before the bone has completely healed. In many cases, the foot can be loaded again after about 6 weeks without pain. Within these six weeks, a plaster cast is applied in many cases in order to achieve complete immobilization of the metatarsus and thus allow the bone fragments to heal correctly.

However, a loading capacity that is close to that before the fracture is usually only achieved much later. Thus, the foot can often only be fully loaded again after half a year. In individual cases, the complete healing phase can last up to one year. Complications that can arise during the treatment and the course of the disease of a metatarsal fracture additionally influence the healing period. Infections and pain that persist even after a few months may require further treatment, which will further prolong the healing of the bone until it is completely free of symptoms.