Fifth metatarsal Fracture


Frattura da stress del quinto metatarso.
Stress fracture of the fifth metatarsal.

A fifth metatarsal bone fracture is a complete or partial break in the external part of the foot.
Fifth metatarsal bone fracture are among the most common injuries in recreational and competitive athletes.
It is a very painful condition that may inabilithates the person.
Pain is local, it doesn’t spread (radiate) around.
Usually , symptoms worsens during the movement and touching the broken bone.

A fracture maybe:

  • open, if the broken bone is exposed, a deep wound exposes the bone through the skin.
  • Closed, if the skin around the fracture is intact,
  • Non-displaced, if the fractured bone fragment are correctly aligned,
  • Displaced, if the broken bone fragment aren’t well aligned,
  • Comminuted, if the broken bone has at least three bone pieces,
  • Stress fracture, many tiny hairline break that happen over time.

 

Anatomy

The fifth metatarsal bone is a small bone at the outer side of the foot.
The fifth metatarsal articulates medially with the fourth metatarsal, proximally with the cuboid bone and distally with the fifth proximal phalanx.

 

What are the causes of fifth metatarsal fracture?

It may occur in several ways:

  • The fifth metatarsal bone can break during an ankle sprain.
  • The fifth metatarsal bone can crack a fall from height .
  • A stress fracture of the V metatarsian can occur because of minor breaks from unusual overuse.

There are some risk factor for fractures( factor increasing the risk of fractures) :

  • Playing certain sport, like football, soccer, running rugby ecc.
  • The Thyroid or endocrine disorders can affect the bone methabolism of calcium absorb

 

Which are the Signs and Symptoms of fractures?

Fracture of V metatarsian bone causes pain over this outside area of your foot and you cannot bear weight on the affected foot.
For the first two or three days, Acute fractures of fifth metatarsal bone causes severe pain and constant, like an aghony.
Another symptoms is inability to walk
About the sings, the affected foot becomes swollen and warm because of the bleeding.
You can experience numbness at the foot (hand) (fingers)
The symptoms aggravate moving the lower toes and touching around the area of the fracture .

 

How is V metatarsian bone fracture diagnosed?

The diagnose of a fracture maybe simple if the bone is exposed.
The physician makes the diagnosis with diagnostic tests and physical examination.
The doctor ask for details about: medical history, risk factors, symptoms and the injury.
During the clinical examination, the physician observethe foot finding signs of fracture such as bruising and swelling.
It is important to check the range of motion and the ability to walk.

Differential Diagnosis


The doctor has to rule out:

  • Foot Contusion,
  • Nerve entrapment,
  • V metatarsian bone  inflammation.

 

What imaging tests or diagnostic procedures need to diagnose V metatarsian bone fracture?

The doctor orders radiograph to confirm the diagnosis and to examine the break.
To rule out other damage he can order another diagnostic procedures: MRI and TC.

 

How is V metatarsian bone fracture treated?

The first thing to do is to go to emergency room where an orthopaedic observe the affected foot and decides the adequate treatment.
If the fracture is open, the surgeon must clean the wound and reposition the pieces immediately to avoid infections.
If the break is out of place the doctor has to reduce the fracture to put the bones back together and stabilize the bone with a cast.
It the rupture)break is comminuted, you need surgery to reposition the fragments to heal before and better.
The doctor must tell the risk with and without surgery at the patient because the benefits depend from medical condition and expectations of the individual.

1. Non operative treatment
The patient require just a brace on the fractured foot to restrict movement and to held together the fragments for at least 4 weeks.
You must avoid weight bear on the affected leg until the orthopaedic permit to walk.
Generally, the patient must repeat radiograph after 30 days from the damage.

2. Operative treatment
You need surgery If

  • Displacement of fragments ,
  • multiple breaks,
  • the fracture has failed to heal.

Tipically displaced fractures require surgery to put-together the pieces in the original orientation.
Surgery can be performed under general or regional anesthesia
Then u need to immobilize the affected foot to permit callus formation.
Caution: surgery maybe dangerous.
After surgery, you have to apply a cast for 15 to 30 days, depending to the orthopaedic orders.
The doctor can prescribe analgesic.

 

Prognosis

You can return to sport activities when you can walk and run without pain, generally it takes between six and twelve weeks.

 
Read also:
 

Tendinitis

Achilles tendinitis

De Quervain

Lateral epicondylitis, tennis elbow

Medial epicondylitis or golfer’s elbow

Patellar tendinitis

Plantar Fasciitis

Pubalgia

Quadriceps tendinitis

Supraspinatus tendinitis – shoulder tendinitis

Osteoarthritis

Hand Osteoarthritis 

Knee Osteoarthritis 

Hip Osteoarthritis 

Fractures

Pelvic fracture

Ribs fracture

Wrist fracture

Fingers fracture

 

Dr. Massimo Defilippo Fisioterapista Tel 0522/260654 Defilippo.massimo@gmail.com
P. IVA 02360680355

http://www.facebook.com/fisioterapiarubierese?ref=hl

http://www.fisioterapiareggio.com

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