Fracture: Toe and Metatarsal

Fracture: Toe and Metatarsal

A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures. Fractures are classified as closed or open (compound) and simple or multi-fragmentary (formerly comminuted).

Closed fractures are those in which the skin is intact, while open (compound) fractures involve wounds that communicate with the fracture and may expose bone to contamination. Open injuries carry an elevated risk of infection; they require antibiotic treatment and usually urgent surgical treatment (debridement). This involves removal of all dirt, contamination, and dead tissue.

Simple fractures are fractures that occur along one line, splitting the bone into two pieces, while multi-fragmentary fractures involve the bone splitting into multiple pieces. A simple, closed fracture is much easier to treat and has a much better prognosis than an open, contaminated fracture. Other considerations in fracture care are displacement (fracture gap) and angulation. If angulation or displacement is large, reduction (manipulation) of the bone may be required and, in adults, frequently requires surgical care. These injuries may take longer to heal than injuries without displacement or angulation.

Examples of Fracture:

Jones: a fracture of the fifth metatarsal of the foot. The fifth metatarsal is at the base of the small toe, and the proximal end, where the Jones fracture occurs, is in the mid-portion of the foot. Patients who sustain a Jones fracture have pain over this middle/outside area of their foot, swelling, and difficulty walking. It may not be an obvious fracture to the patient, and could be mistaken for a sprain.

Lisfranc: a fracture and dislocation of the joints in the midfoot, where a cluster of small bones forms an arch on top of the foot between the ankle and the toes. From this cluster, five long bones, the metatarsals, extend until the toes.

Pott's: fracture of the fibula near the ankle, often accompanied by a break of the medial malleolus of the tibia or rupture and displacement of the internal lateral ligament.

Trimalleolar: a fracture of the ankle that involves the lateral malleolus, medial malleolus and the distal posterior aspect of the tibia, the posterior malleolus.

Treatment for stress and traumatic fracture varied depending of the break itself. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.