Marching foot (March fracture of the metatarsal bone of the foot, the disease of Dahlander): symptoms, treatment
March foot stress fracture caused by lifestyle
Foot marching is a disease associated with a pathological change in the structure of the metatarsal bones, which are caused by excessive strain on the foot.
This violation is also called March fracture, or overload of the foot disease Dahlander. The disease is not a tumor or an inflammatory process.
This kind of pathological restructuring of the diaphyseal bone (Central division bones). The special examination revealed local lacunar resorption of bone with subsequent replacement of new bone structures.
Metatarsal is the most vulnerable part of the foot. When a marching fracture the most common affected bone 2, rarely 3, and 4 5 — very rarely. 1 bone is not affected at all ever in view of the fact that it has a higher density.
Often damaged only one metatarsal bone, but sometimes the damage is diagnosed simultaneously or with a gradual involvement of several bones.
The main predisposing factor to the development of this condition — flat feet. Also among the reasons there are:
- physical activity;
- wearing uncomfortable shoes;
- a weak physical training.
The risk group includes soldiers who are getting into a new environment for them to be completely unprepared for long-term intensive training, people whose professions are connected with standing on her feet, carrying of Pro athletes.
Very often there are cases when a person goes on a hike without adequate training and in terms of the long walk and carrying heavy loads becomes a victim of this disease.
Clinical picture and forms of the disease
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There are two forms of the disease Dahlander:
- acute — occurs 2-4 days after exposure to the load (a rare form);
- primary-chronic — develops slowly on the rise.
Patients experience severe pain in the Central part of the foot that can sometimes be unbearable. This disturbed gait, the man begins to limp and trying not to step on the injured leg.
As a result of examination revealed dense swelling and swelling in the affected area (on the outside of the foot). The sensitivity of the skin in this area increases. Rare redness.
Interesting is the fact that the disease does not occur Dahlander characteristic symptoms, such as high temperature or change biokhimicheskoi in the blood picture.
The average duration of the disease is just a few months, but it could go much faster. Pain present throughout the course of the disease.
The main fracture has a fairly distinct clinical picture and can not occur latent, so patient, experiencing severe pain and discomfort, immediately consult a doctor.
First of all, for diagnosis used x-ray and initial examination.
Since the main stop is a closed pearl, x-rays may be inadequate due to the fact that the picture will be missing the characteristic lines of the fracture (especially at the beginning of the disease).
If the gave no result, the specialist uses a method of palpation. The diagnosis will be obvious if there is swelling, but also if during probing of the foot the patient will feel a strong sharp pain.
Sometimes for diagnostics of damage of the metatarsal bones using magnetic resonance diagnostics, in particular this method is relevant if the recent damage.
There are also several stages of pathological changes of the metatarsal bones, which are taken into account in the diagnosis:
- Identify the primary signs of transformation of the structure of the diaphysis and periosteum that surrounds it. In cross section or slightly random will be seen homogeneous enlightenment with a diameter of a few millimeters. Around the diaphysis in a region of enlightenment is formed external callus.
- The increase in the outer layers, the acquisition of bony structures with clear signs of stratification. Dense layers on the x-ray viewed poorly.
- Enlightenment on the x-ray is not visible due to excessive outer layers. The diaphysis undergoes thickening and deformed. The pain become less intense.
- The outer layers gradually dissolve, the structure of the division of bone recovered, on the x-ray image would be visible thickening with clear smooth edges.
Approach to therapy
When marching fatigue fractures apply conservative treatment. The goal of therapy — relief of acute painful symptoms and eliminating the underlying mechanism that triggered the disease. Surgical intervention in this case does not apply never.
First of all, the patient is placed on the foot plaster splints and prescribed bed rest, which shall be not less than a week. Man must be free from prolonged standing and walking because of a damaged leg needed a complete rest. Once the pain becomes less intense, you can use the following methods:
- thermal baths;
- paraffin or ozokerite applications;
- creams and gels warming action (for example, Fastum-gel);
- sometimes prescribers non-steroidal group to help with swelling and pain: Aspirin, Ibuprofen, Voltaren;
- foot baths using sea salt or herbal collection;
- physiotherapy to relax the leg muscles, with exercises should not assume the involvement stop.
It’s also essential in the rehabilitation period the patient is prescribed the wearing of orthotic insoles and arch supports.
What it all could lead?
Conservative therapeutic methods will always produce excellent results in the treatment of marching feet, but in any case can not let the disease fester. The lack of proper treatment and rehabilitation can lead to changes in anatomical features of the foot and the violation of its functions.
What complications can occur with this disease:
- the weakening of the muscular-ligamentous complex of the foot;
- the flattening of the arches and loss of shock absorbing ability;
- flat feet;
- deforming arthrosis of the foot;
- chronic pain whining character, which make themselves felt when walking;
- neuroma is the result of the load on the soft tissue.
Pathological changes in the bones of the foot and the simultaneous weakening of its shock-absorbing function contribute to the fact that increasing the load on the remaining joints of the legs, pelvis and lumbar spine. Increases the likelihood of such diseases as arthritis, arthrosis, osteochondrosis, spondylosis.
In addition, increases the risk of frequent injury to the knee and ankle joints, as well as the development of herniated discs.
After treatment to prevent recurrence the patient will need to adhere to the following rules:
- in the near future to abandon long walks over long distances;
- avoid prolonged standing on the feet;
- to exclude those sports in which there will be a strong impact on the lower limbs (e.g., running);
- only wear comfortable shoes, flat platform to exclude, would be the actual shoes with a small elevation and an inner soft cushion in the instep area of the foot;
- at the end of the day to do a relaxing foot bath;
- systematically undergo special massage.
The prognosis of marching foot fracture is always positive. With timely detection of problems and quick referral for medical assistance, you can achieve the most speedy cure.
It is always worth remembering that to go on a serious camping trip, which involves heavy loads without prior training, it is impossible. Those who have suffered this injury, it is recommended to replace a kind of activity that involves standing on my feet, wearing heavy or constant movement over long distances.
March fracture is not a reason to forget about sports and in General, about the active lifestyle, the cardinal rule is that any physical activity should be moderate.