Metatarsal fracture

　　Among the five metatarsal bones of the foot, the first metatarsal is the largest and thickest, with a relatively low risk of fracture. The second to fourth metatarsals have the highest risk of fracture. The base of the fifth metatarsal, being cancellous bone, often fractures due to the violent contraction of the peroneus brevis muscle. In most cases, metatarsal fractures are caused by direct violence, such as heavy objects striking or wheels crushing. In a few cases, long-term chronic injuries (such as long-distance running, marching) can lead to fatigue fractures of the second or third metatarsal shafts.

　　After injury, metatarsal fractures can cause foot pain, swelling, subcutaneous ecchymosis, shortening and deformity of the foot, and inability to walk. Examination may find localized tenderness at the fracture site, longitudinal percussion pain, and pain and functional disability during movement; metatarsal fractures can occur at the base, shaft, and neck of the metatarsal. After the base fracture of the metatarsal, the distal fracture end often moves downward and backward, which may compress or injure the arch of the plantar artery. If there is also injury or incomplete compensation of the dorsal artery of the foot, anterior foot necrosis may occur. The fracture of the metatarsal shaft can appear transverse, oblique, or comminuted fractures due to the size and direction of the violence, which may lead to foot deformity, infection, disability, and other complications after healing.

　　After metatarsal fracture, the foot may have pain, swelling, subcutaneous ecchymosis, shortening and deformity of the foot, and inability to walk. Examination may find localized tenderness at the fracture site, longitudinal percussion pain, and anteroposterior, lateral, and oblique X-ray films of the forefoot can accurately determine the location, type, and displacement of the fracture.

　　To prevent metatarsal fractures, it is necessary to avoid traumatic behaviors. In daily life and work, do a good job of safety protection, avoid the direct action of violence on the body, causing fractures, and at the same time, choose appropriate shoes to avoid sprains.

　　Metatarsal fractures are common fractures, often caused by heavy objects striking the top of the foot, rolling, inward inversion sprains, or kicking hard objects. How can you determine if a foot injury is a fracture? The following introduces what examinations need to be done to diagnose a fracture of the foot.

　　1. X-ray examination is of great value for the diagnosis and treatment of fractures:

　　All suspected fractures should undergo routine X-ray film examination, which can show incomplete fractures, deep fractures, intra-articular fractures, and small avulsion fractures that are difficult to detect clinically. Even if clinical manifestations of obvious fractures have occurred, X-ray film examination is still necessary and can help understand the type and specific situation of the fracture, which is of guiding significance for treatment.

　　2. X-ray films should include anteroposterior and lateral views, and it must include the adjacent joints. Sometimes, oblique, tangential, or contralateral corresponding part X-ray films may need to be taken. After carefully reading the X-ray films, the following points should be identified:

　　(1) Whether the fracture is traumatic or pathological.

　　(2) Whether the fracture has been displaced and how it has been displaced.

　　(3) Whether the alignment of the fracture is satisfactory and whether it needs to be reduced.

　　(4) Whether the fracture is fresh or old.

　　(5) Whether there is damage to the adjacent joint or bone injury.

　　The above are the examinations that metatarsal fracture patients need to do, which are of great value for diagnosis and treatment of fractures. Generally, X-ray examination is required for patients with fractures.

　　To ensure the early healing of the fractured metatarsal, it is first necessary to ensure the intake of necessary nutrients for bone growth in the diet. The requirements for diet vary at different stages after the fracture, what should be paid attention to in the diet of patients after metatarsal fracture surgery?

　　1. Early stage of metatarsal fracture (1-2 weeks):

　　The injured part has ecchymosis and swelling, obstruction of meridians and collaterals, and blockage of Qi and blood. At this stage, the treatment focuses on promoting blood circulation and removing blood stasis, and dissipating Qi. According to traditional Chinese medicine, 'if the blood stasis is not removed, the bone cannot grow' and 'if the blood stasis is removed, new bone will grow'. It can be seen that removing swelling and blood stasis is the primary factor for fracture healing. The early stage of metatarsal fracture is mostly the period of immobilization. At this time, it should be avoided to eat greasy bone soup and a large amount of difficult-to-digest meat, and it is not advisable to consume a high amount of calcium. The diet should be easy to digest and absorb, and tonifying should be placed in the middle and late stages of metatarsal fracture to play a role in nourishment. The principle of diet during the early stage of metatarsal fracture should be light, such as vegetables, eggs, soy products, fruits, fish soup, lean meat, etc. Avoid eating sour and spicy, dry and hot, and greasy foods, especially not to apply greasy tonifying foods such as bone soup, fatty chicken, stewed water fish, etc. Otherwise, blood stasis will accumulate and be difficult to dissipate, which will lead to a delay in the course of the disease, slow down the growth of the callus, and affect the recovery of joint function in the future. At this stage, food therapy can use 10 grams of Panax notoginseng, 10 grams of Angelica sinensis, 1 pigeon, stewed until tender, and consume the soup and meat together. Take once a day, for 7-10 days consecutively. In the early stage of fracture, due to less movement and worry, Qi stagnation, and lack of strength to push and move, constipation is common, especially in bedridden patients. Avoid eating yams, taros, glutinous rice, and other foods that are easy to cause flatulence or are difficult to digest. Eat more vegetables rich in fiber, and eat some bananas, honey, and other foods that promote defecation.

　　2. Middle stage of metatarsal fracture (2-4 weeks):

　　Most of the ecchymosis has absorbed. At this stage, the treatment focuses on harmonizing the nutrient and relieving pain, removing blood stasis and promoting new growth, and connecting bones and tendons. At this time, the callus begins to grow. Some patients, after a period of bed rest, are in a state of high metabolism, with a significant loss of potassium, calcium, and other trace elements. The diet should gradually shift from light to high-nutrient supplementation, actively consuming vitamins, calcium, potassium, zinc, and other trace elements to meet the needs of callus growth. The initial diet can be supplemented with bone soup, Cordyceps chicken stew, animal liver, etc., to provide more vitamin A, D, calcium, and protein. Food therapy can use 10 grams of Angelica sinensis, 15 grams of wolfberry, 15 grams of bone碎补, 10 grams of 续断, 250 grams of fresh pork ribs or beef ribs, stewed for more than 1 hour, and consume the soup and meat together. Take for 2 weeks consecutively.

　　3. Late stage of metatarsal fracture (more than 5 weeks):

　　After 5 weeks of injury, the ecchymosis at the site of the metatarsal fracture has basically absorbed, and there is already new bone formation, which is the late stage of fracture. Treatment should focus on supplementation, through tonifying the liver and kidney, and nourishing the Qi and blood to promote the formation of a stronger callus, and to relax the tendons and meridians, so that the adjacent joints of the fractured part can move freely and flexibly, restoring the function of the past. Diet restrictions can be lifted, and the diet can be supplemented with old hen soup, pork bone soup, lamb bone soup, deer tendons soup, stewed water fish, etc. Those who can drink can choose Du Zhong bone碎补 wine, chicken blood vine wine, tiger bone papaya wine, etc. Food therapy can use 10 grams of wolfberry, 15 grams of bone碎补, 10 grams of续断, 50 grams of Job's tears. First decoct the bone碎补 and 续断 to remove the dregs, then add the remaining two ingredients to cook porridge for consumption. Take once a day, with a course of 7 days. The interval between each course is 3-5 days, and 3-4 courses can be used.

　　The above are the dietary precautions for metatarsal fracture patients. Scientific and reasonable diet is conducive to the recovery of the disease, shortens the recovery time, so diet is very important for the recovery of the disease, and should be paid attention to.

　　Metatarsal fracture is a common fracture, often caused by heavy objects striking the back of the foot, rolling and foot inversion sprain. Metatarsal fracture can be treated by surgery or conservative treatment. The following introduces the traditional Chinese medicine treatment for metatarsal fracture.

　　1. Traction:

　　The degree of fracture has two situations: angular fracture or bone breakage. The traction is to pull the bones apart through the muscle force, and then compound the bones between them. The main function of this method of treating fractures is to counteract the muscle force to correct the overlap displacement of the bone ends and restore the length of the limb.

　　2. Rotation and return:

　　Due to the external force, the bone breaks, and the broken bone is pulled back by the muscle force after breaking, causing the bone to rotate and dislocate. This kind of fracture is difficult to recover to its original position, and the broken ends cannot be directly pulled back. At this time, it is necessary to use the muscle force to rotate and stretch in the opposite direction at the same time, so that it can return to its original position. This technique mainly solves the rotation and backward displacement between the fracture ends. This is a good method of treating fractures.

　　3. Touch the heart:

　　The so-called 'touch the heart with the hand' is equivalent to the ancient methods of observation, listening, asking, and touching. Relying on years of medical experience, during the process of touching, the direction of bone displacement is found through the x-ray diagram. This method of treating fractures mainly makes a general analysis of the fracture situation.

　　4. Flexion and extension:

　　It is aimed at the condition of bone curvature fractures, and adjustments are made according to the size of the angle. The main solution is the angular displacement between the fracture ends. This is also a common method of treating fractures.

　　Orthopedic experts remind:Apply ice packs to the injured area within 24 hours of fracture, which can reduce bleeding and prevent the occurrence of compartment syndrome. It is necessary to go to a professional orthopedic hospital for treatment after injury.