What is a Metatarsal Fracture?
A metatarsal fracture is a break/crack in one of the five long bones of the midfoot. These fractures range from small stress fractures to displaced breaks involving multiple fragments. They may affect one or more metatarsals and result from direct injury, repetitive stress, or twisting forces. Depending on the type and severity, treatment can range from rest and supportive footwear to surgery.
The metatarsal bones play a critical role in supporting weight and enabling walking, running, and balance. A fracture can significantly impact mobility and requires prompt treatment to prevent long-term issues.
Types of Metatarsal Fractures and Mechanism of Injury
Metatarsal fractures typically occur in one of several patterns.
- Stress fractures are small cracks/breaks in the bone. They are caused by overuse, often seen in runners and athletes.
- Transverse fractures run straight across the bone and are usually caused by direct impact.
- Oblique or spiral fractures result from twisting injuries.
- Comminuted fractures are described when the bone breaks into multiple pieces, and may occur with high-impact trauma or crush injuries.
- An avulsion fracture happens when a tendon or ligament is stretched too far and tears off a small fragment of bone.
The mechanism of injury for most metatarsal fractures includes dropping a heavy object onto the foot, twisting the foot unexpectedly, or sudden overuse, particularly during running or high-impact sports. Stress fractures often develop gradually, whereas traumatic fractures occur suddenly.
Symptoms and Diagnosis of Metatarsal Fractures
The symptoms of a metatarsal fracture can vary depending on the severity. Common symptoms include pain in the midfoot, especially when walking or standing, swelling, bruising, and sometimes a visible deformity. Tenderness to touch over the affected bone and difficulty bearing weight are also common.
Diagnosis involves a physical examination, during which the clinician assesses for pain, swelling, and alignment. X-rays are the primary imaging tool used to confirm a fracture and determine its type and severity. In some cases, if a stress fracture is suspected but not visible on X-ray, MRI or CT scans may be used for further assessment.
Treatment Approaches for Metatarsal Fractures
Treatment for a metatarsal fracture depends on the type, location, and severity of the injury. Many fractures can be managed conservatively with R.I.C.E. (Rest, Ice, Compression, Elevation), immobilisation in a boot or stiff-soled shoe, and activity modification. For stress fractures, rest from high-impact activities is essential.
Buddy taping or partial weight-bearing with crutches may be used in less severe cases. More complex fractures—such as displaced or comminuted fractures—may require reduction (realignment) or surgical fixation using screws or plates.
Prognosis for Metatarsal Fractures
Most metatarsal fractures heal well with appropriate care. Simple, non-displaced fractures usually recover within 6–8 weeks, while stress fractures may require slightly longer due to the risk of recurrence. Surgical cases can take several months to fully heal. Prompt diagnosis and management help prevent complications such as chronic pain, non-union, deformity, or arthritis, especially when the fracture involves a joint surface.
Role of Access Ortho in Diagnosing and Treating Metatarsal Fractures
Access Ortho offers fast, expert care for metatarsal fractures. We provide rapid appointments, referral and review of X-rays, and direct access to orthopaedic clinicians. Our team ensures accurate diagnosis and tailors treatment plans to the specific type of fracture, whether conservative or surgical. With a focus on specialist musculoskeletal care, Access Ortho helps patients avoid emergency department delays, recover faster, and minimise the risk of long-term complications.