Midfoot fracture

Definition/Introduction

The metatarsal fracture is a fracture of the metatarsal bones. It is often caused by falling objects, traffic accidents or sports injuries. About 1/3 of all foot fractures are metatarsal fractures. The healing process is typically uncomplicated and the incidence of infection or permanent chronic complaints is low.

Cause

Acute traumas or stress fractures are often the cause of a metatarsal fracture. Stress fractures are usually the answer to chronic overload. Accordingly, athletes (dancers, runners, footballers) are particularly often affected by this type of fracture. Since the metatarsal bones are fixed by strong ligaments, such a fracture is rare in cases of minor trauma.

Indications

A metatarsal fracture is caused by a force applied to the bony structures. This can either act on the foot from the outside or be caused by bending the foot. If, after such a situation, strong load-dependent pain develops in the foot, which is accompanied by a rapidly occurring swelling, this is to be understood as the first sign of a metatarsal fracture.

The bruise on the foot, which sets in a little later, reinforces the suspicion of a metatarsal fracture. In order to be able to say with certainty that a metatarsal fracture is present, however, an X-ray must be taken. Often the ligament structures and muscles are more likely to be affected.

The subcapital metatarsal bones are an exception to this rule, as they are not fixed as firmly and can therefore easily be moved backwards. In severe traumas, several metatarsals are often involved. Especially the soft tissue involvement plays a very important role in these cases.

In addition, a massive trauma can lead to instability of the entire foot column. In such cases, compartment syndrome of the foot should be ruled out. This involves a significantly increased tissue pressure in a closed section. This increased pressure leads to tissue damage, as well as compression of the vascular and nerve supply, and thus represents an emergency.