Metatarsal fracture – How long are you on sick leave?
The healing of a fracture depends not only on the type and severity of the fracture, but always also on accompanying factors such as age, concomitant diseases and external circumstances. In addition to the duration of healing, the demands on the patient are also important in order to be able to assess the duration of a sick leave. A patient who is able to relieve the strain on his foot in everyday professional life and does not need a secure stand will be able to return to work sooner than, for example, a patient who has to stand or walk a lot.
Metatarsal fracture without swelling – is this possible?
A fracture is usually also accompanied by swelling because the bone tissue is injured and bleeding occurs. Traumatization leads to a local inflammatory reaction. There is increased leakage of tissue fluid.
The area becomes red and warm. However, metatarsal fractures also frequently occur in the form of a fatigue fracture. Here the bone breaks without any previous trauma, e.g. when jogging, because the bone is no longer stable enough due to constant overloading.
Here, swelling may be absent or may be much more subtle than after a traumatic fracture. In the case of a fatigue fracture, the patient suffers from movement-related pain, is unable to put proper weight on the foot and can often indicate a relatively localized point of pain. However, the foot is neither severely swollen nor can a bruise be seen.
Frequently, a fatigue fracture can only be detected in an X-ray. The swelling is then more subtle because it is not an acute tissue reaction with inflammation, but rather a chronic process. The tissue is rather undersupplied. As a rule, there is no heavy bleeding, and there is no swelling.
Fatigue fracture
Fatigue fracture is also a cause of metatarsal fractures and occurs particularly in intensive training and sports. The fracture is classified according to its location. The metatarsal bone, the Os metatarsal, is divided into a head (caput), a body or shaft (corpus) and a base.
Depending on where the bone is broken, a distinction is made between a base fracture, a shaft fracture, a subcapital fracture and a head fracture. The fracture of the 5th metatarsal bone is again individually classified into different categories (e.g. Jones fracture). Most fractures are luxation fractures, which involve dislocation of the joint close to the body (Lisfranc joint).
Only the shaft fracture is not counted as a dislocation fracture. A serial fracture, i.e. the breaking of several bones, is common in the metatarsal region. Fatigue fractures in the metatarsal bone are common, the diagnosis is usually lengthy and is made by means of an X-ray.
Pain occurs depending on the load, the foot may be swollen, and hematoma formation is possible.But as already described, swelling and hematoma formation can also be avoided. Mostly the 2nd metatarsal is affected. The symptoms can be gradual.
The therapy is often lengthy due to the slow progress and the late seeking of medical help. If there is a dislocation (shifting, twisting) of the fracture, surgery is usually unavoidable. More often, however, conservative therapy using immobilization and subsequent physiotherapy is sufficient.
The longer the problem is present, the more complex the therapy is usually. In physiotherapy for a fatigue fracture, a training analysis is carried out to counteract possible incorrect or excessive stress. The patient’s statics are muscularly corrected and muscular imbalances are compensated. A slow, controlled increase in load is essential to prevent further damage.
