Is metatarsal fracture serious?

The metatarsal bones are composed of five long bones. Among the many fractures, metatarsal fracture is the most common fracture in clinical practice. Among them, the first metatarsal is the thickest and has a lower chance of fracture, while the second to fourth metatarsal bones have the highest chance of fracture. The causes are mostly caused by heavy blows, crushing and inversion of the foot. Inversion of the foot is a developmental deformity, which can be found when the child is born and is caused by spasm of the posterior tibialis muscle.

Although metatarsal bones are prone to fracture, are metatarsal fractures serious?

Causes of disease:

Among the five metatarsal bones of the foot, the first metatarsal is the thickest and has a lower chance of fracture. The 2nd to 4th metatarsal bones have the highest chance of fracture. Since the base of the fifth metatarsal is cancellous bone, it often fractures due to the violent contraction of the peroneus brevis muscle. In most cases, metatarsal fractures are caused by direct violence, such as being hit by a heavy object, being run over by a wheel, etc. In a few cases, long-term chronic injuries (such as long-distance running and marching) lead to fatigue fractures of the second or third metatarsal shaft.

Diagnostic tests:

After the injury, the foot will be painful, swollen, with subcutaneous ecchymosis, shortened and deformed, and unable to walk. Examination may reveal localized tenderness at the fracture site and longitudinal tapping pain. Anteroposterior, lateral and oblique X-rays of the forefoot can accurately determine the location, type and displacement of the fracture.

Treatment options:

Fractures of the base of the 2nd to 4th metatarsal bones often have downward and backward displacement and may cause blood circulation disorders in the forefoot. Emergency manual reduction and external fixation with plaster are required after the injury. If manual reduction fails, an intramedullary nail is inserted through the underside of the metatarsal head and the end of the bone nail is passed through the tarsal bone for internal fixation. Simple fifth metatarsal base fractures can be fixed in the valgus position with a bandage or plaster for 4-6 weeks before functional exercises can be performed.

A single metatarsal shaft fracture without displacement does not require special treatment and the patient can walk again after resting for 3-4 weeks. Multiple metatarsal shaft fractures with displacement require manual reduction. If this is unsuccessful, open reduction is performed and an intramedullary nail is inserted under the metatarsal head for fixation for 4-6 weeks.

For displaced cervical fractures, manual reduction should be tried first, and then fix with a plaster splint. Before the plaster hardens, it must be carefully plasticized to ensure that the fracture ends are well fixed. If manual reduction fails, open reduction and cross-pin internal fixation are performed, and the pins can be removed after 4-6 weeks. Weight-bearing walking is allowed after the bone has healed firmly.

1. Diet care

Beneficial:

1. High-energy, high-protein diet: helps to restore vitality. However, it is best to eat it 2 weeks after the fracture. In the early stages of a fracture, a light diet is recommended.

2. Vitamin D: If you stay indoors after a fracture and cannot get enough sunlight, you may easily become deficient in vitamin D. Therefore, after a fracture, you should eat more foods rich in vitamin D (such as fish, liver, egg yolks, etc.) and get as much sun as possible.

3. Vitamin C: Fruits rich in vitamin C include hawthorn, fresh dates, kiwi, strawberry, longan, lychee, citrus, etc. Vegetables include alfalfa (grass head), pepper, sweet pepper, rapeseed, cauliflower, Brussels sprouts (soup vegetables), bitter gourd, watercress, broccoli, amaranth, etc.

4. Water: After a fracture, sitting for a long time can easily cause constipation. At this time, you should drink more water to ensure smooth intestinal flow.

Contraindications:

1. Bone soup: Many people believe that bone soup can supplement calcium. In fact, the calcium in the bones cannot be directly absorbed by the human body. The main nutrient in bone soup is collagen. Eating more collagen is beneficial for patients with fractures, but it is not advisable to eat too much within 1-2 weeks after a fracture, because it is too greasy and may cause blood stasis, affecting recovery.

2. Calcium supplementation: Although calcium is an important component of bones, calcium supplementation is not beneficial for treating fractures. On the contrary, it may cause increased blood calcium. If the fracture patient is not calcium deficient, simply strengthening functional exercise can promote the body's absorption of calcium and accelerate the healing of broken bones. Calcium supplementation should not be done blindly.

3. Indigestible food: Fracture patients often have poor appetite due to long-term rest at home and swelling and pain in the injured area. If you eat too much nutritious and greasy food, it will not only make you lose your appetite, but also cause constipation. Therefore, after a fracture, you should eat more foods that are good for digestion and bowel movements, and avoid eating foods that are easy to cause bloating or indigestion, such as sweet potatoes, taro, and glutinous rice.

4. Sugar: Excessive consumption of sugar after a fracture can lead to a large loss of calcium, which is not conducive to the recovery of fracture patients. Too much white sugar will also reduce the content of vitamin B1 in the body. Insufficient vitamin B1 will greatly reduce the activity of nerves and muscles and affect the recovery of functions.

5. Panax notoginseng tablets: Taking Panax notoginseng tablets in the early stage of fracture can constrict local blood vessels and treat fracture bleeding. However, one week after the fracture has recovered, the bleeding has stopped and the injured bone needs a fresh blood supply to recover quickly. Taking Panax notoginseng tablets at this time will cause the blood vessels to be in a state of contraction, blood circulation will be poor, and it will be detrimental to fracture healing. [1]