A metatarsal fracture occurs when one of the long bones of the midfoot is cracked or broken. This may be due to sudden injury (an acute fracture), or due to repeated stress (stress fracture).
Where are the metatarsal bones?
The metatarsal bones are some of the most commonly broken (fractured) bones in the foot. There are five metatarsal bones in each foot. They are the long slim bones which run the length of the foot to the base of the toes.
A metatarsal fracture is a break in one of the five long bones which form the middle part of your foot. The fifth metatarsal bone is the most common metatarsal bone to be fractured in sudden (acute) injury to the foot. It may be broken at various points along its length, depending on the mechanism of injury. The other metatarsal bones can also be broken. The first, second and fifth metatarsals are the most commonly injured in sport. Several well-known footballers have had metatarsal fractures in recent years.
Are there different types of break?
Breaks (fractures) can be acute, or caused immediately by injury. They can also occur over a longer period of time when they are called stress fractures.
Acute metatarsal fractures may be open or closed, and displaced or nor displaced:
- Open or closed: an open fracture is one where the skin is broken over the fracture so that there is a route of possible infection from the outside into the broken bones. This is a more serious type of fracture, with more damage to the soft tissues around it making treatment and healing more complicated. Specialist assessment is needed.
- Displaced or not displaced: a displaced fracture is one where, following the break, the bones have slipped out of line. A displaced fracture needs specialist care, as the bones will need to be properly lined up and stabilised. This may involve an anaesthetic and some kind of metal pinning or plating to the bones.
Acute metatarsal fracture is usually caused by a sudden forceful injury to the foot, such as dropping a heavy object on to the foot, a fall, kicking against a hard object when tripping, or from a sporting injury.
A stress fracture is a hairline break in a bone, caused by repetitive stress. This is cracking which goes only partway through the bone. There may be a single split in the bone, or multiple small splits. The hairline break or breaks do not go through the full thickness of the bone, so stress fractures are not generally displaced. However, several small stress fractures can develop around the same area, over time.
Further reading and references
Fredericson M, Jennings F, Beaulieu C, et al; Stress fractures in athletes. Top Magn Reson Imaging. 2006 Oct17(5):309-25.
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