Metatarsal fracture

A fracture is called a metatarsal fracture when one of the long thin bones of the foot is fractured. It is also known as broken foot, and can be classified as Jones fracture, stress fracture of the foot, Lisfranc fracture dislocation, marcher's fracture, tennis fracture and dancer's fracture. Human foot has five metatarsal bones. Depending on the extent of injury and displacement, metatarsal fractures can be classified as minor or severe injuries. When this fracture occurs in an area of the foot where there is poor blood flow, the healing is more difficult. Jones Fracture is of this type and requires surgery to position the bones.

Twisting and dropping a heavy object on the foot are the two major causes for most of the metatarsal fractures. Direct impact of the falling object will result in a metatarsal fracture. Since the symptoms of this type of fracture may be similar to an ankle sprain, a metatarsal fracture may be missed at times. Though X-rays will help to confirm the fracture, a CT scan or MRI is needed only when there are other injuries.

Keeping the injured foot at an elevated position will help to reduce the pain. One can use crutches to avoid pressure on the foot. Stiff soled shoe or a walking cast can be used as part of the treatment. A non-weight bearing cast for several weeks is prescribed for more severe fractures.If a metatarsal fracture has occurred in an area of the foot that has poor blood supply or if the bones are very much out of place, surgery is recommended. Maintaining good balance, good coordination and strength of the foot are some tips one should remember to avoid metatarsal fractures.

Femur fracture

The word 'femur' is taken from Latin meaning 'thigh'. The femur is the thigh bone and it is the largest and strongest bone in the human body. The femur bone extends from the hip to the knee joint. A femur fracture can be life threatening. Since the inside of the thigh is a place of major blood vessels, broken femur means break in the artery. Femur fracture is also called femoral shaft fracture, femur injury, femur stress fracture, fractured femur, femur trauma and femoral diaphyseal fracture. Femur is a tremendously strong bone. It usually requires a great deal of force to break the femur bone. The most common causes for femur fractures include:

• Falls from a great height
  
• Blows that are strong in force
  
• Car accidents and Collisions
  
• Severe twists
  
• Bones weakened by osteoporosis, tumor or infection leading to a condition called pathologic femur fracture.
  

Proximal femur fracture: This involves fracture in the uppermost portion of the thighbone adjacent to the hip joint. are further sub divided into different types.

Femoral shaft fracture: The femoral shaft fracture is a severe injury that occurs during high-speed motor vehicle collisions and significant falls. Injuries caused by femoral shaft fractures are usually severe. Treatment of femoral shaft fracture is always with surgery. The common procedure is to insert a metal rod bone, called 'intramedullary rod' down the center of the thigh. The two ends of the bone are connected by the rod. This intramedullary rod usually remains in the bone for the life of the patient but can be removed if it causes pain and other problems.

Supracondylar femur fracture: In this kind of fracture, the injury occurs just above the knee joint. Cartilage surface of the knee joint is usually involved in this fracture. Patients who sustain supracondylar femur fracture are at high risk of developing knee arthritis later. Supracondylar femur fracture is common in patients with severe osteoporosis. Patients who have undergone total knee replacement surgery also run the risk of this fracture. Treatment for supracondylar femur fracture is highly variable. A cast or brace, external fixator, plate, screws or intramedullary rod are used for treatment.

Symptoms of femur fracture include swelling, bruising and severe pain. There may be numbness or paralysis in the leg below the femur fracture. Femur fractures are apparent and visible in many cases. Apart from clinical examination by the orthopaedic, for non-apparent fractures, a bone scan is required. Treatment for fractures of femur depends upon various factors such as the patient's age, type of fracture, location of the break, bone stability in the injured, mechanism of injury, direction of the blow, factors of twisting, existence of internal bleeding and extent of soft tissue damage. Some of the methods of treatment are:

• Reduction or re-alignment
  
• Immobilization whereby the movement is restricted
  
• Insertion of an intramedullary fixation
  
• A cast
  
• External fixation such as a frame on the outside of the leg anchored into the bone using pins.
  

• Pain or arthritis
  
• Rotational deformity due to misalignment
  
• Infections in open fractures
  
• Uneven leg length
  
• Injury of blood vessels
  
• Nerve damage
  
• Compartment syndrome
  
• Amputation
  
• Failure to heal - 'non-union' is also a possibility
  

Intra articular sepsis, arthritis and knee stiffness are some of the permanent complications that can occur among persons who have undergone femur fracture and treatment. Sometimes femur fracture is bound to cause permanent disability in injured persons. This is due to the thigh muscle pull and incorrect reunion of fragments when they overlap. Femur fracture patients should be careful not to put weight on the leg as this can delay the healing process.

Jones Fracture

Fracture of the fifth metatarsal of the foot is called Jones fracture or dancers fracture. The fifth metatarsal is located at the base of the small toe. This injury is named after Sir Robert Jones who originally explained this injury in 1902. Jones fracture usually is caused due to the wear and tear of the bone. When the bone is used more than the required limit, it leads to a stress fracture. Symptoms of Jones fracture include tenderness of the foot and swelling, thereby leading to difficulty in walking. There may be pain on the middle or outside area of the foot.

• A cast is made to support the injured area.
  
• No weight should be balanced on the injured foot.
  
• The foot has to be kept immobile till the recovery.
  
• Raise the level of the foot above the chest level, this eases the swelling.
  
• Crutches can be used to move around during the early phase of recovery.
  
• If the fracture takes a prolonged period to heal and if the injury is severe then a surgery might be recommended.
  
  

Jones fracture occurs primarily due to accidents. Use the right type of shoes or slippers and exercise care while walking fast or running on uneven surfaces. Jones fracture has to be treated at the initial levels itself to prevent it from worsening.