What are the complications of metatarsal fractures?
If properly treated then metatarsal fractures should heal without long-term consequences. If not recognised and treated then some of these problems can occur:
- A metatarsal stress fracture can become gradually worse if repeated stress to the bone continues. It can eventually become a full-thickness metatarsal fracture.
- A fracture of the first metatarsal bone can lead to later arthritis of the big toe joint.
- A fracture at the base of the fifth metatarsal bone is often mistaken for an ankle sprain and therefore not rested or supported enough. This can lead to problems in healing and continuing pain.
- A full-thickness fracture which is displaced and not 'put back' into line can heal 'out of shape', leading to deformity of the foot, sometimes making shoe fitting difficult. The foot may be painful.
- Acute metatarsal fracture can also, occasionally, lead to 'non-union', which is when the two ends of broken bone stop trying to heal because movement between them makes this impossible. This may lead to reduced ability of the foot to cope with stresses and strains of walking and running and it may also lead to chronic pain in the foot.
Can metatarsal stress fractures be prevented?
There are a number of things that you can do to help prevent stress fractures. Exercise intensity and duration should be built up slowly and gradually. Rest and recovery time needs to be built in to any training schedule. Footwear should be well fitting and suit your running style. If changing - for example, from supportive training shoes to barefoot running shoes - you should be shown how to adapt your style. You should practise this gradually. You should be aware of the symptoms of stress fractures, and should not continue to run on a painful foot.
If stress fractures are recognised and treated quickly, this can reduce the amount of time that you need to stay away from activities.
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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