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Metatarsal and Phalangeal (Forefoot) Fractures

Justin Hudson, M.D., Orthopedic Surgeon & Sports Medicine Specialist, Eugene, OR / Patient Info / Foot & Ankle / Foot & Ankle Conditions / Metatarsal and Phalangeal (Forefoot) Fractures
Metatarsal and Phalangeal (Forefoot) Fractures

Forefoot Fractures

The forefoot is the anterior or front portion of the foot that functions in weight-bearing and maintaining balance while standing, walking or running. It is formed by 5 metatarsal bones, 14 phalange bones, and various soft tissues. A forefoot fracture is a crack or breaks in any of these bones. In some cases, the broken bone can protrude through the skin. These are called open fractures. 

Causes

Traumatic fractures occur when there is a direct impact of your foot on a hard surface. Stress fractures are tiny hairline cracks in the bone, most often caused due to repeated stress. Stress fractures are common in dancers, runners, and athletes. 

Symptoms

The common symptoms of forefoot fracture include:

  • Cracking sound at the time of injury
  • Pain
  • Bruising
  • Swelling
  • Tingling sensation
  • Blue or gray colored skin
  • Inability to walk
  • Nail injury
  • Deformity (if untreated)

Diagnosis

Your doctor will physically examine the forefoot and assess the injury. An X-ray will be ordered to examine the fracture more closely. 

Treatment

The treatment options include:

  • Medications: Prescribed pain medications may be given to manage pain.
  • Rest: Adequate rest can heal a traumatic fracture.
  • Splinting: Splints may be applied to keep the toe in a fixed position.
  • Rigid shoe: A stiff-soled shoe may be recommended to protect the toe and position it correctly.
  • Buddy-taping: The fractured toe is taped to the adjacent toe with a gauze pad between the toes.

Surgery is recommended if you do not respond to non-surgical treatment options. The surgery is performed under local anesthesia. Your surgeon realigns the fractured bones using pins or screws to hold the bones together in place until they heal completely. Follow-up X-rays may be ordered to monitor complete healing which may take about 6-8 weeks.

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