The Most Common Foot fracture

28 Year Old Man

While painting a wall, my patient dropped a piece of wood on top of his foot.  The wood landed right above the safety boot area not covered by steel.   Immediately, following the trauma, the patient felt numb and swelling begun to accumulate in the area.  The around on the top aspect of the foot (closer to the toe said) was extremely sensitive to touch. Furthermore, bruising was evident.  The patient went home and began to ice the area.  The next day he decided that he would go get a foot x-ray. The x-ray showed a metatarsal fracture!

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Metatarsal fractures are the most common traumatic foot injuries.  What are the metatarsals?  Well, the foot consist of a total of 26 bones.

These 26 bones consist of:

• The phalanges or the toe bones ( 14 in all);
• Metetarsals or forefoot bones (5 in all); and
• Seven tarsal bones

The tarsal bones include:

• 3 cuneiforms (medial, intermediate and lateral);
• The cuboid bone;
• The navicular bone;
• The calacaneus or heel bone; and
• The talus bone which lies just below the ankle joint.

There are a total of five Metatarsal bones in each foot. These are relatively long bones which are located between the tarsal bones of the hind-foot and the phalanges bones in the toes. The ankle and foot have two functions: propulsion (push us forward) and support. The Metatarsal bones play a major role in these functions. For instance, for propulsion they act like a rigid lever and for support they act like a flexible structure that aids balance. Bottom line – they assist in holding the entire body and assist in moving us forward.

Injuries usually occur to these bones due to direct trauma, excessive rotational forces or overuse.  Soccer players usually obtain these injuries when they get stepped on in the foot area by another player wearing soccer shoes with clits (traumatic).  Furthermore, metatarsal fractures can occur if something drops on top of the foot (traumatic).  Overuse can cause stress fractures of the Metatarsals.  These type of fractures are common in army recruits as ‘march’ fractures.

The patient was advised that he did not require a cast.  He was referred to our clinic for chiropractic and physiotherapy.  At our clinic, we treated this particular condition with laser therapy, ultrasound and electrotherapy.  Furthermore, we educated the patient about RICE (Rest, ICE, Compression and Elevation of the foot to remove swelling).   The patient was treated 2-3 times per week for 5 weeks.  At week 5, the patient explained that he was 100% better.

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

Dr. Luciano Di Loreto, HBSc., DC