Pain in a metatarsal fracture

introduction

A metatarsal fracture is a fracture of one or more bones in the metatarsus. The metatarsus is located between the tarsal bones and the phalanges of the toes and represents the counterpart to the palm of the foot. In medical jargon, a metatarsal fracture is also used to describe a metatarsal fracture.
A metatarsal fracture can cause great pain and severely limit the person's daily mobility. There is a different approach to therapy between the complicated and the simple metatarsal fracture:
Simple fractures can be treated by immobilization, while complex fractures require surgical treatment. The therapy also focuses on combating pain, which can be very severe in the case of a metatarsal fracture.

causes

The causes that cause a metatarsal fracture include traumatic events: If an object falls on the foot from a great height, it is usually either Toe phalanges or the Metatarsus affected. Such fractures are particularly common on construction sites or in factories. It is not for nothing that safety precautions often apply in these areas that prescribe shoes reinforced with steel toes.
Another cause of metatarsal fractures is found in the competitive sport: There is one leading permanent burden of the metatarsus in extreme cases also to fracture. In fact, this case is relatively common and is called Fatigue fracture designated. It occurs when the bones are mechanically overstressed over a long period of time. This can be the case with marathon runners, for example. In the case of the federal government, this type of fracture is also tellingly "March fracture“Called because it can appear after long marches with a lot of luggage and inadequate shoes.
A few other causes of the metatarsal fracture have already been named: Unsuitable, pressing shoes can promote a fracture. With every kilo of body weight, the load on the fine statics of the increases Arch of the foot. If jumps are also carried out, or if - as in a forest run - bumps often have to be leveled out, this makes things even more difficult.

Pain and symptoms

The main symptom of the metatarsal fracture is stronger Pain when stepping on, which usually makes any movement impossible. On the one hand, this is due to the fact that the entire body weight is always on the foot. On the other hand, the body always reacts very sensitively to further stress in the case of bone fractures. This is a signal to keep us from further, damaging movements.
With everyone further movement of the metatarsus the broken bones to and through the Periosteum. This is highly sensitive because it is tight Nerve plexus is streaked. This immediately sends violent pain impulses to the brain as soon as we continue to use the foot. The pain usually subsides at rest.
Other symptoms of a fracture besides pain are general restricted mobility, Creaking noises when moving, and swelling. As a rule, vessels that bleed into the foot and cause hematomas are also affected.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Diagnosis of metatarsal fracture

The diagnosis of a metatarsal fracture is based - taking into account the severe pain - on the clinical examination in combination with a X-ray examination. In the clinical examination, the doctor asks the the accident and can use the position of the foot, painful pressure points and any misalignment of the foot to get a relatively precise picture.However, this is always followed by an X-ray examination, as this is the only way to diagnose the exact extent and type of the break. If the bone has broken through smoothly and not displaced, it is an uncomplicated fracture that can be treated conservatively. Fractures with multiple fracture fragments and obvious malalignment are described as complicated and must be treated surgically.

therapy

First of all, the focus is on to fight severe pain. To do this, stand by the doctor Analgesics - so painkillers - are available. In principle, according to a level scheme specified by the WHO (World Health Organization), "Non-Opioid-Analgesics "worked, so commercial painkillers like Ibuprofen, or Paracetamol. Only when these are not enough will low potency opioids how Tilidine used. However, the pain is rarely so severe that it is used.
As soon as the pain has been combated, the actual treatment of the fracture can begin. The fraction will - if it is shifted - repositioned, that is, the bone is returned to its original position, and in a Plaster splint immobilized. The immobilization takes place for 6-8 weeks. Since the foot cannot be loaded during this time, an additional supply of forearm crutches ("crutches") is provided. For predisposed patients, a Thrombosis prophylaxis done to Thrombosis to prevent.

With more complicated fracture forms you lose one surgery not around. Since a “crooked” growing together of the bones leads to incorrect loading of the entire foot in the long run, joints and muscles can degenerate over the years. To prevent this, the fracture is then minimally invasive via a small incision with a screw provided. The screw pulls the separated pieces of bone back together and puts pressure on them. The pressure accelerates healing.
In the case of comminuted fractures, the individual Bone fragments on a plate be fixed. For this purpose, each piece of bone is individually placed on a so-called Osteosynthesis plate attached. It is important to bring the bone pieces back into the correct anatomical position. The bone pieces then grow together inside 6-8 weeks among themselves. During this time a must also plaster be worn. Within the next 2-3 weeks the foot can increasingly burdened until a full load is possible again after a good 10 weeks. The healing time depends of course on the age and constitution of the patient.
after the swelling around the metatarsal fracture has subsided, the pain should also go away. The swollen tissues presses on the surrounding nerve fibers for a while until the pressure slowly subsides and the pain subsides. If the pain remains unchanged after a week, there may be a crushing or damage to the nerves. This can also be done with Numbness go hand in hand and should definitely be clarified at an early stage.

Please also read our text "Metatarsal fracture therapy'

prophylaxis

A metatarsal fracture from stress is relatively easy to avoid by exercising in to a healthy degree operates. Jogging is a good "fat burner". However is obese Patients are more likely to lose weight initially joint-friendly To advise sports such as swimming or cycling. Competitive athletes should always keep in mind that a metatarsal fracture means the end of the training season and if you don't take care of yourself chronic consequential damage threaten. Of course, you should pay attention to suitable footwear, which distributes the body weight ideally over the entire foot. In particular from competitive athletes you occasionally hear that they ignore their pain and - sometimes with the help of painkillers - continue training beyond the pain. This false ambition becomes noticeable at the latest in old age, when the joints suffer from osteoarthritis and every step causes pain.