These pins may then be removed in the office in about 6-10 weeks. If surgery is needed, the bones can often be realigned and held in place with temporary pins. This is especially true for fractures involving the first metatarsal. These include fractures that have poked through the skin, and any fractures that are so separated that they do not line up well enough to heal or work properly afterwards. There are some metatarsal fractures that benefit from surgery.
After a period of healing, you may begin a slow return to activity. You will likely be advised to stay off the foot for 4-6 weeks or even longer until the pain subsides. If you are diagnosed with a stress fracture of the metatarsal, you will be advised to stop the activity that caused it. You may be able to place more pressure on your foot over time. As your broken bone(s) heal over 8-12 weeks, your pain will decrease. Your treating physician will decide this. The amount of pressure you are able to put on your foot will depend on which bones are broken. A stiff soled shoe, walking boot, or even a cast may be used. Most metatarsal fractures can be treated without surgery. You should also elevate your foot as much as possible for the first 2-3 days, and apply ice to help decrease the swelling as well as your pain. If the bone did not poke through the skin, the emergency room provider will typically put you in a splint (half cast), place you on crutches, prescribe medications to help you deal with your pain, and advise you to follow up with either your primary care provider or an orthopaedic surgeon. The diagnosis is usually made by taking x-rays. You may decide to go to an emergency room or to your primary care doctor. If your metatarsal fracture is the result of a crush or twisting injury, the pain will likely be great enough to make you seek immediate medical attention. Video Library: Annual Meeting & Conferencesįigure 4: Stress fracture of the 2nd metatarsal.OTA Orthopaedic Trauma References & Resources.Disaster Management and Emergency Preparedness.OTA Support of Federal Grant Applications.You can buy arch supports over-the-counter, or they can be custom fitted. If insoles don't help, your doctor might recommend arch supports to minimize stress on the metatarsal bones and improve foot function. These off-the-shelf pads are placed in your shoes just ahead of the metatarsal bone to help deflect stress from the painful area. Wear shoes appropriate to the sports you play. Avoid too-tight or too-loose shoes and limit your wearing of high heels. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or aspirin to reduce pain and inflammation. Take an over-the-counter pain reliever.To protect your skin, wrap the ice packs in a thin towel.
Apply ice packs to the affected area for about 20 minutes at a time several times a day. You might need to avoid your favorite sport for a while, but you can stay fit with low-impact exercises, such as swimming or cycling. Elevate your foot after standing or walking. Protect your foot from further injury by not stressing it. To help ease your metatarsalgia pain, try these tips:
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