Injuries of the forefoot
Injuries of the forefoot are often due to its exposed position.
More or less heavy and sharp objects may fall off the hand and hit the forefoot. That is why craftsmen, construction workers and similar professional groups should wear steel-toed shoes.
Small soft tissue injuries are treated like any other normal wound, a bandage is usually sufficient.
Larger wounds should be treated surgically and also definitely need an x-ray, as the foot has little soft tissue padding and the bones are very close to the surface. A tetanus prophylaxis is important and must not be neglected. Note that foot injuries can be very painful for longer time periods and therefore need an adequate treatment and rest.
Toe fractures are usually treated using a tape, the broken toe is fixed with one or more neighboring toes, which then act as a splint and provide the necessary rest during the healing phase. This tape should be applied for at least 4 weeks. Strongly shifted or dislocated fractures should be treated surgically, which usually involves the use of wires. Severed tendons have to be sewn.
Relatively often after forefoot injuries, pain and swelling remain for several months or longer, depending on the tissue quality. Pre-swelling, varicose veins and circulation disorders and systemic diseases such as diabetes impair the healing tendency.
In case of the metatarsal there is an expression: march fracture.
These are fractures that occur mostly after long walks or other heavy burdening. X-rays often show no signs initially, but only after a while can callus be seen as a sign of operation. These fractures are very painful, so patients can barely walk often.
Treatment: Rest, ice packs and tape dressing, well-adjusted shoe inserts. The pain often fades away only after 2 to 4 weeks. Surgical treatment of a march fracture is almost never necessary.
Left: March fracture at the shaft of the metatarsal II, already healing, showing significant callus.
Another injury of the forefoot, namely the displaced shaft fracture of the fifth metatarsal needs surgical intervention.
Right: After repositioning and screw fixation on an oblique fracture of the fifth metatarsal.