Foot fracture: injury of the metatarsal, cuboid and other bones
What to do when signs of foot fracture: first aid and treatment
The broken foot is one of the most common types of fracture.
A huge number of bones in the foot, enormous loads which these bones have to withstand on a daily basis, the lack of minimal knowledge about the prevention of fractures of the foot make this a challenging anatomical education are particularly vulnerable.
Foot – the lower part of the lower extremity that have vaulted the structure and designed to absorb shocks that occur when walking, jumping, and falling.
The foot performs two main functions:
- first of all, keep a body weight;
- second, provide movement of the body in space.
These functions determine the structural features of the brake: 26 bones in each foot (a quarter of all existing in the human body bones is in the feet) that connects the bones joints, a large number of powerful ligaments, muscles, vessels and nerves.
Sedentary joints, and ligaments elastic and high strength, therefore, the dislocation of the foot occurs much less frequently than fracture.
Since we will focus on fractures, pay particular attention to the bony skeleton of the foot, which consists of the following bones:
- Heel. It is the largest bone of the foot. Has the shape of a complex three-dimensional rectangle with depressions and projections, which are attached to muscles and which nerves, vessels and tendons.
- Talus (nadpochechnaja). Is the second largest unique highest percentage of the articular surface and those that do not contain any fixing bones or tendons. Consists of head, body and the connecting neck, which is the least resistant to fractures.
- Cuboid. Located in front of the calcaneus closer to the outer part of the foot. Forms the arch of the foot and forms a groove, through which can fully work the tendon of the long peroneal muscle.
- Navicular. Forms a joint with the talus and the three cuneiform bones. Occasionally the development of this bone is broken, and there may be 27-the first bone of the foot — plus navicular bone connected with the main cartilage. Unskilled reading renthenznimky plus the bone is often mistaken for a fracture.
- Wedge-shaped. On all sides attached to other bones.
- The metatarsal. Short tubular bones are used for depreciation.
- Phalanges. Similar to the phalanges of the fingers by the number and location (two flanks for large fingers and three on every other finger), but shorter and thicker.
- Sesamoid. Two very small (smaller than a pea), but it is extremely important round bones located within the tendons and are responsible for flexion of the first toe of the foot, which accounts for the maximum load.
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Every tenth every third fracture and a closed fracture of the falls on foot (servicemen this figure is slightly higher and amounts to 13.8% in peacetime).
Among fractures of the foot occur most frequently:
- the talus is less than 1%, of which about 30% of cases lead to disability;
- the heel is 4%, of which 83% — as a result of the jump on straight legs from a great height;
- cuboid — 2,5%;
- navicular — 2,3%;
- the metatarsal is the most common type of injury bones of the foot.
And for athletes, the characteristic fracture of the fifth metatarsal bone under excessive stress, and for people experiencing unusual excessive load, often in uncomfortable shoes, — a fracture of a second, sometimes 3 or 4, and rarely 1 or 5.
The average duration of incapacity for injured toes 19 days. For children this injury is not typical, occur incomplete fractures (cracks).
At a young age, often split fractures, after 50 years – is pressed.
The cause of trauma
The fractures of foot bones can occur for several reasons:
- drop heavy objects on the foot;
- jump (fall) from a great height and landing on feet;
- when you kick;
- when you hit the leg;
- when subluxation of the foot, from walking on uneven surfaces.
Features of fractures of the different bones
There are different types of fractures depending on the bone that was injured.
The main cause is landing on your heels when jumping from a considerable height, the second most common — a strong blow in an accident. At impact the body weight is transmitted to the talus, it cuts into the heel and splits it into parts.
Fractures are usually unilateral, usually complicated.
Of special note is the fatigue fracture of the calcaneus, the main reason – a chronic overload of bone with anatomic defects.
It should be noted that the mere presence of the anatomical defect to fracture does not, for its occurrence requires a sustained rather serious burden, so often a fracture is observed in recruits in the army and Amateur athletes neglect medical examination before appointment to the high loads.
Injury of the talus
The relatively rare fracture, which occurs as a result of falling from a great height, car accidents or bumps and is often combined with injuries of the lumbar spine and other fractures (of the bones of the foot are usually suffering along with the talus heel).
The injury is considered severe in a third of cases leads to disability. This situation is due to triggered by trauma a lack of blood circulation.
Even if the vessels are torn as a result of compression of the supply of nutrients bone is broken, the fracture heals very long time.
The main cause of fracture – fall on the leg of a heavy object, possible fracture due to shock.
As is clear from the mechanism of occurrence, usually one-sided.
Fracture of the scaphoid
Formed in the fall of a heavy object on the back foot at the moment when the bone is in tension. The characteristic displaced fracture in combination with fractures to other bones of the foot.
In recent years, there are stress fractures of the navicular bone that was once a rarity, is primarily due to the increase in the number of Amateur sportsmen who do without medical and coaching support.
Damage to the sphenoid bone
The consequence of a fall on the dorsum of the foot of a heavy object and crushing the sphenoid bone between the metatarsal and the navicular.
This mechanism of emergence is that the fractures are usually multiple, often combined with dislocations of the metatarsal bones.
The most commonly diagnosed, are divided into traumatic (resulting from a direct blow or povertyline
feet) and fatigue (arise as a result of deformity, long-term repetitive stress, improper shoes, osteoporosis, pathological bone structure).
Fatigue fracture is often incomplete (it does not go beyond a crack in the bone).
Injury to the phalanges
A fairly common fracture, usually caused by direct trauma.
The phalanges are deprived of protection from external influences, especially of the distal phalanges of the first and second fingers, which are noticeably forward compared to the others.
It is possible to observe almost the entire range of fractures encountered fractures transverse, oblique, T-shaped, and comminuted. The offset, if there is, then, as a rule, at the proximal phalanx of the thumb.
Complicated, in addition to displacement, the penetration of infection through the damaged nail bed, therefore requires a sanitary treatment of the fracture even if the fracture is at first glance seems closed.
A relatively rare type of fracture. Small bones located under the end of the metatarsal bone of the big toe, are broken usually due to sports related to high load on the heel (basketball, tennis, a long walk).
Sometimes it’s easier to remove the sesamoid bones than to treat the fracture.
Symptoms depending on location
Symptoms of foot fractures regardless of the view:
- the inability to walk,
- bleeding in trauma,
- changing the shape of the foot when the fracture with displacement.
May be not all of the symptoms, the severity of symptoms depends on the specific injury.
- if the talus fracture: the talus shift (noticeable on palpation), pain while trying to wiggle my thumb, the sharp pain in his ankle during movement, the foot is in a position of flexion;
- when the cuboid and scaphoid fractures: acute pain in the location of the relevant bones, attempting to take or to cause the forefoot, swelling of the entire front surface of the ankle joint.
Diagnosis is usually to x-ray study, which is conducted in one or two dimensions depending on the location of the alleged fracture.
If you suspect a fracture of the talus x-ray uninformative, the optimal method of diagnosis stands computed tomography.
The only first aid for suspected fracture of the foot — ensuring the immobility of the foot. It is carried out in mild cases, a ban on the movement, the rest by a splint.
Then the victim should be transported to the clinic. If you experience swelling you can apply cold.
It is determined based on several factors:
- view broken bones;
- closed fracture or open;
- complete or incomplete (crack).
Treatment consists of the imposition of plaster splint, plaster bandage, bandage or latch, surgical or conservative treatment, including physical therapy and special massage.
Surgical treatment is carried out in exceptional cases — such as fractures of the sphenoid bone with an offset (in this case, the operation with transarticular fixing a metal K-wire) or fractures of the sesamoid bones.
Recovery after injury
Recovery from injury is achieved by a special massage and physical therapy, reducing stress on the injured limb, application of orthopedic insoles, arch supports, heel cushions and refusal to wear heels for a long period.
Fractures of the sphenoid bone may experience prolonged pain.
Complications are rare, with the exception of very rare fractures of the talus.
Fractures of the foot are not dangerous to life. However, the quality of later life largely depends on whether the injured treatment.
It is therefore important when experiencing symptoms of trauma not to self-medicate, and seek professional medical help.
In addition, I would like to draw the attention of non-professional athletes and athletes that mindless higher loads and use the proper shoes when playing is a direct way to close yourself the opportunity to exercise forever.
Even high-quality recovery after the foot injury never to return to swarnakamalam training. To prevent is always easier than to cure.