A 5th metatarsal fracture has to be operated on
Metatarsal fracture treatment
Conservative methods of treatment
Metatarsal fracture: treatment without surgeryIf there is a fatigue fracture, the cause must be found. Metabolic disorders and possible malnutrition must be excluded. Overloads, such as long walks (marching fracture), can also cause a fracture. Misaligned feet can lead to overload, so that a fracture only occurs over months. Often these are not shifted and can only be seen with difficulty or not at all on an X-ray. Magnetic resonance tomography often provides the proof here. Treatment is then primarily aimed at treating the cause. Once this has been resolved, the fatigue fracture usually heals on its own.
Accidental fractures are usually treated conservatively. We initially immobilize your foot in a lower leg cast / cast boot / walker for six to eight weeks. In addition, your foot is relieved by forearm crutches. To prevent thrombosis, you have to wear ready-to-wear shoes until you can put full weight on your foot again. Decongestant measures such as lymphatic drainage can also be useful.
In patients with poor bone condition, we can stimulate bone healing with ultrasound.
Operative treatment methods
Metatarsal fracture: treatment with surgeryFatigue fracture: We bring your fracture back into the correct position
If there is no healing under conservative therapy, sometimes a fatigue fracture has to be treated surgically. For example, osteoarthritis in the area of the big toe or a hallux valgus malalignment can lead to a relieving posture and overloading of the outer edge of the foot. Often the fracture is not surgically treated at all, but rather the osteoarthritis or deformity in the area of the big toe, for example. If necessary, we can stimulate bone healing by injecting growth factors from your own blood.
Jones fracture: thanks to screws, your fracture can heal well
A special form of the fatigue fracture is the Jones fracture. It is a fracture in the area of the fifth metatarsal bone. This area is poorly supplied with blood. Sports with rapid changes of direction, such as tennis or soccer, can overload the bone, which can lead to a creeping fracture. Misalignments of the foot, such as a hollow foot, can further promote the development of a Jones fracture due to the overloading of the outer edge of the foot. Due to the poor blood circulation at this point and the high shear forces, conservative healing is very slow and there is no new bone formation. A screw implant neutralizes the shear forces and thus improves bone healing. The procedure is carried out very gently using the minimally invasive procedure. Since we only have to make a very small incision in the skin, the risk of wound infection or impaired wound healing is reduced. The screw absorbs the tensile force of the tendon of the short fibula muscle and directs it away over the fracture so that it can heal in peace. As a result, the load can often be built up more quickly in the case of simple fractures. Your operated foot will be immobilized in a cast boot / walker for six weeks. Depending on the healing, you can then put light weight on the foot again and gradually increase the load after two to three weeks.
Debris fracture: we stabilize your bones with a plate
In the event of a debris fracture, the individual bone parts can be threaded with a wire like a pearl necklace. This is inserted under fluoroscopy. The surrounding soft tissues remain intact, which promotes healing and minimizes the risk of surgery. If joints are also affected, the so-called plate osteosynthesis is often used: Here the individual bone fragments or joint parts are reassembled step by step and held in the correct position with screws and a plate. Your foot must then be relieved in the walker for six weeks.
Lisfranc fracture: we bring your joints back into position
In the case of complicated injury patterns such as the sprained fractures on the Lisfranc joint line, we need to know the exact course of the accident. After a careful diagnosis using magnetic resonance or computer tomography, we will bring your joints back into position using an incision on the back of your foot. We then immobilize your joints using screws or wires for eight to twelve weeks. Do not put any weight on your foot during this time. Your follow-up treatment takes place in a lower leg cast or a cast boot. Your foot is completely relieved by forearm crutches. After six to eight weeks, a second, albeit smaller, operation will take place in which we remove the screws or wires from your foot. You can then carefully begin building up the load.
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