A high index of suspicion is required and urgent fasciotomies performed if clinically suspected. Crush injuries are mainly transverse or comminuted and are associated with compartment syndrome of the foot. The mechanism of injury can be variable from RTA to crush injury. Zwipp (2004) described the AO classification of injuries of the foot (as applied to the metatarsalsĪs with all fractures they can present with pain, swelling, bruising and deformity.Whilst not as well defined as the 5th MT fracture, there are several classifications that can be used. All IIIB fractures resulted in an amputation secondary to infection and poor wound healing because of significant soft tissue damage( 1 toe, 1 ray, and 2 Symes). There is next to no literature on 1st metatarsal fractures case reports suggest they are commonest at the proximal metaphysisĪ retrospective study of 10 open metatarsal fractures (Hoxie 2007), contained 4 grade I, 2 grade II and 4 grade IIIB fractures. 3rd and 4th mainly occur in the distal metaphysis. Second metatarsal fractures are commonest in the diaphysis and distal metaphysis. Fracture of the 4th MT is uncommon because of the flexibility of the ray and its protected position, and of the 1st because of its relative size and mobility. Other studies show similar figures with 2nd and 3rd more common than 1st and 4th.(Sanchez 1996, Rammelt 2004). Nine percent had multiple fractures, 1.2% were open and 1.9% had an associated Lisfranc injury The overall incidence was 6.7 per 10,000 population. Petrisor (2006), looked retrospectively at 355 patients with 411 metatarsal fractures. In children 61% of foot fractures are in the metatarsals. Most of the literature and studies available relate to stress fractures rather than acute injury of the metatarsals with mainly case reports and very small studies on acute fractures. The metatarsals also the most common site of stress fractures in the skeleton. 2nd and 3rd MT fractures are more commonly seen than 1st and 4th, and all these fractures are less common than 5th metatarsal fractures. You can contact the Virtual Trauma Assessment ClinicĮmail: 087 1989980 (1.30-2.Metatarsal injuries range from simple fractures to severe crush injuries with multiple fractures and soft tissue damage. You will be provided with more information on weaning from the boot and return to activity during your phone call from the clinic. However, it may take several months for your symptoms to settle fully. Most fractures heal without problems over 6-12 weeks. Then repeat rotating your ankle in the opposite direction Repeat 10 times Gently rotate your ankle in a circle first moving clockwise. Then gently roll the sole of your foot outwards (as if trying to look under your little toe). Sitting or lying, gently roll the sole of your foot inwards (as if you are trying to look under your big toe). In sitting or lying down point your toes to the ground and then bend them back to point your toes towards your head. We recommend you do the exercises below 4 times daily. For more information, contact the National Quit Hotline on 1800 201 203, freetext QUIT to 50100 or visit ExerciseĮarly range of motion exercises for your ankle and toe are important to promote circulation and reduce stiffness. We would advise you to stop smoking, at least for the duration of the healing process. Research suggests that smoking slows down fracture healing time. Do not apply ice directly to the skin as is may cause a burn. We recommend applying ice wrapped in a damp towel for 15 minutes, 3-4 times per day. You can apply ice to help with pain and swelling.Swelling can be reduced by resting the leg in elevation (above the level of your hip).Please speak to a pharmacist or your GP if you require further advice regarding pain relief.
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