Metatarsal (Foot) Fracture

Description

This is a break of a metatarsal — one of the long bones in the middle of the foot that lead to the toes — from a twist, a fall, or a dropped object. (Breaks of the fifth metatarsal, on the outer foot, have their own considerations and their own handout.)

How it happens (the mechanism)

A direct blow, a twist, or a crush breaks one of the long foot bones. The inner metatarsals are well-supported by their neighbors and have a good blood supply, so they generally heal dependably; the outer (fifth) metatarsal is the exception that gets singled out, because one specific spot there heals more slowly.

Symptoms

Pain, swelling, and bruising over the middle of the foot, with difficulty bearing weight.

Doctor examination and imaging

The doctor checks the foot’s alignment and tenderness; X-rays show the fracture, its angle, and how many bones are involved.

Treatment

Most are treated with a cast or a stiff-soled walking boot, with weight-bearing as tolerated. A significantly displaced fracture, or several broken together, may occasionally need realignment or a pin.

Recovery and long-term outlook

Most metatarsal fractures in children heal well, typically in four to six weeks, with full return to activity.

When to call the doctor

Call if pain is severe or worsening, your child will not bear weight or use the leg at all, the area becomes very swollen, red, or warm, your child develops a fever, or things are not improving with rest as expected.

Learn more

OrthoInfo (AAOS) — Toe and Forefoot Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.