General
The metatarsal bones (medical: Ossa metatarsalia) connect the toes of the foot with the so-called tarsal. There are therefore five metatarsals on each foot. The fracture of one of these bones is usually caused by a considerable direct or indirect force acting on the foot.
In addition to objects falling on the foot, accidents and sports injuries are among the most common causes of metatarsal fractures. If a metatarsal fracture is suspected, a doctor should be consulted, who can confirm the diagnosis and initiate therapy if necessary. Depending on the severity of the fracture and the concomitant injuries that frequently occur with a metatarsal fracture, the prognosis of such an injury can be assessed differently. A simple metatarsal fracture without major soft tissue injuries should return to normal after about six months. In individual cases, however, the healing period can be delayed beyond that.
Cause
A large proportion of fractures of the foot affect the metatarsal bones. Due to falling objects or indirect force applied in an accident, these bones break faster than other structures on the foot and are therefore often affected by fractures. However, it is noteworthy that a high force is required to break the metatarsal bones as they have a strong stabilization through numerous ligaments and muscles.
If the metatarsals break at low intensity, it is recommended to check the ligamentous apparatus and the bone density in order to rule out possible diseases that could be responsible for the break. Furthermore, athletes who add stress to the metatarsal structures are statistically often affected by metatarsal fractures. In particular, these are dancers or athletes with a high running load.
A fatigue fracture or generally a fracture of the metatarsal bone is understood to be an interruption of the continuity of the corresponding bone. If the bone is “tired” it is no longer resistant enough to withstand a load, so it breaks. A fatigue fracture of the metatarsal bone can also be called a stress or march fracture.
The metatarsal is a typical site of fatigue fractures. The 2nd metatarsal is the most commonly affected area. As a result of a strong, long-lasting mechanical load or overloading, the metatarsal bone is no longer able to keep up with its physiological adaptation processes in response to the load.
As a result, it gives way and a fracture occurs. However, in comparison to metatarsal fractures caused by trauma, a fatigue fracture does not occur suddenly and unexpectedly. It is rather a gradual process.
The respective metatarsal reacts to the stress initially with signs of fatigue such as small cracks in the bone. The resistance decreases over the course of time, because the metatarsal bone is not able to repair the small cracks in the bone structure due to a continuous heavy load. At some point, the metatarsal bone is no longer strong enough and breaks. In general, competitive athletes from the running area or people who put a disproportionately high and long strain on their metatarsus without being used to such a strain are particularly at risk. Also soldiers or hikers are susceptible to a so-called marching fracture, i.e. a fatigue fracture.
