Health Library

A metatarsal fracture is a break in one of the five bones that connect the toes to the rest of the foot. This may also be called a forefoot fracture. A metatarsal fracture may be:

1. A crack in the surface of the bone (stress fracture). This often occurs in athletes.
2. A break all the way through the bone (complete fracture).

The bone that connects to the little toe (fifth metatarsal) is most commonly fractured. Ballet dancers and other athletes often fracture this bone.

What are the causes?

A metatarsal fracture may be caused by:

1. Sudden twisting of the foot.
2. Falling onto the foot.
3. Something heavy falling onto the foot.
4. Overuse or repeated exercise.

What increases the risk?

This condition is more likely to develop in people who:

1. Play contact sports.
2. Are runners.
3. Do ballet.
4. Have weak bones (osteoporosis).
5. Have low calcium levels.

What are the signs or symptoms?

Symptoms of this condition include:

1. Pain that gets worse when walking or standing.
2. Pain when pressing on the foot or moving the toes.
3. Swelling.
4. Bruising on the top or bottom of the foot.

How is this diagnosed?

This condition may be diagnosed based on:

1. Your symptoms.
2. Any recent foot injuries you have had.
3. A physical exam.

An X-ray of your foot. If you have a stress fracture, it may not show up on an X-ray. You may need other imaging tests, such as:

1. A bone scan.
2. CT scan.
3. MRI.

How is this treated?

Treatment depends on how severe your fracture is and how the pieces of the broken bone line up with each other (alignment). Treatment may involve:

1. Wearing a cast, splint, or supportive boot on your foot.
2. Using crutches and notputting any weight on your foot.
3. Having surgery to align broken bones and hold them in place while they heal (open reduction and internal fixation or percutaneous pinning).
4. Physical therapy exercises to improve movement and strength in your foot.

Follow these instructions at home:

If you have a removable splint or boot:

1. Wear the splint or boot as told by your health care provider. Remove it only as told by your provider.
2. Check the skin around the splint or boot every day. Tell your provider about any concerns.
3. Loosen the splint or boot if your toes tingle, become numb, or turn cold and blue.
4. Keep the splint or boot clean and dry.

If you have a nonremovable cast:

1. Do not put pressure on any part of the cast until it is fully hardened. This may take several hours.
2. Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
3. Check the skin around the cast every day. Tell your provider about any concerns.
4. You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
5. Keep the cast clean and dry.

Bathing

If the cast, splint, or boot is not waterproof:

1. Do not let it get wet.
2. Cover it with a watertight covering when you take a bath or shower.

Activity

1. Do not use your affected leg to support your body weight until your provider says that you can. Use crutches as told by your provider.
2. Ask your provider what activities are safe for you during recovery. Ask what activities you need to avoid.
3. Do exercises as told by your provider.

Driving

1. Ask your provider if the medicine prescribed to you requires you to avoid driving or using machinery.
2. Do not drive while wearing a cast, splint, or boot on a foot that you use for driving.

If told, put ice on the painful area.

1. If you have a removable splint or boot, remove it as told by your provider.
2. Put ice in a plastic bag.
3. Place a towel between your skin and the bag or between your cast and the bag.
4. Leave the ice on for 20 minutes, 2–3 times a day.
5. If your skin turns bright red, remove the ice right away to prevent skin damage. The risk of damage is higher if you cannot feel pain, heat, or cold.
6. Move your toes often to reduce stiffness and swelling.
7. Raise (elevate) your lower leg above the level of your heart while you are sitting or lying down.

General instructions

1. Take over-the-counter and prescription medicines only as told by your provider.
2. Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. These can delay bone healing. If you need help quitting, ask your provider.
3. Do not take baths, swim, or use a hot tub until your provider approves. Ask your provider if you may take showers.
4. Keep all follow-up visits. Your provider will check to see how you are healing. This may include more X-rays.

Contact a health care provider if:

1. You have pain that gets worse or does not improve with medicine.
2. You have a fever.
3. You have a bad smell coming from your cast or splint or if the cast or splint gets wet.

Get help right away if:

You have any of the following in your toes or foot, even after loosening your splint (if you have one):

1. Numbness.
2. Tingling.
3. Coldness.
4. Blue skin.
5. Redness or swelling that gets worse.
6. You have pain that suddenly becomes severe.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.