Stress fracture of the foot - causes, symptoms and treatment. Marching fracture of the metatarsal bone Step fracture of the foot

A lot of people are susceptible to a marching fracture, including runners, track and field athletes, army recruits, and enthusiasts. different types fitness and aerobics, dedicated lovers of heels, increasing pressure on the forefoot, too active tourists and shopaholics.

What is a march fracture

A marching fracture is a damage to the metatarsal bone that occurs as a result of excessive and prolonged physical stress on the foot. Marching foot can also occur in people who wear “wrong” shoes, which redistribute the load on the forefoot and thereby overload it. Metatarsal fractures are accompanied by pain and swelling of the soft tissues of the foot. There is no specific treatment method for this type of fracture; at the site of injury, the broken parts of the bones heal on their own. The main thing for the victim is to ensure complete rest for his lower limbs and not to put any unnecessary strain on them.

Causes of marching foot

Causes of a marching foot fracture

Conscripts are considered first on the list of those most susceptible to a march fracture of the metatarsal bone. Harsh army conditions, unusual shoes, sudden overwhelming physical exertion and exhausting forced marches - all this creates unbearable conditions for vulnerable and thin bones; they break from excessive and prolonged pressure. The second metatarsal bone suffers the most, while the third and fourth suffer slightly less. In very rare cases, fractures of the first and fifth metatarsal bones of the foot occur. This fracture was even named after soldiers who selflessly march in military service and break bones in their feet in the process.

Tourists are at risk of a march fracture

The risk group for marching foot fractures includes tourists who experience pain while on vacation and travel, while sightseeing, walking, shopping, and so on. The feet of women who prefer heels are especially affected, even during relaxation. Their metatarsal bones break, unable to withstand the extreme strain.

Marching foot often occurs in avid athletes, both men and women, with extensive experience and sports experience. The reason for this may be intensive preparation for competitions, a change in style sports shoes, performing complex exercises after a long break, or without prior preparation.

This unpleasant disease also accompanies representatives of certain professions characterized by prolonged standing, walking, carrying heavy objects, and so on. This category includes hairdressers and movers, medical staff, salespeople, waiters, bartenders, tour guides, and so on.

In all cases, the provoking and predetermining factor is the presence of flat feet, physical unpreparedness, as well as wearing uncomfortable and tight shoes. Marching foot can occur in acute or chronic form; one or several metatarsal bones can break on one or both legs. However, the course of the disease almost always ends in complete recovery without complications.

Symptoms and diagnosis of a march fracture

Signs of a marching foot fracture

The main symptoms of a march fracture are pain and slight swelling over the broken bone. However, the X-ray will not show the characteristic fracture line of the metatarsal bones, since they break like a “green stick” - only the internal structures are damaged, and thin bone tissue remains at the top, connecting the edges of the broken bones. As a result, it should take from 4 to 6 weeks for X-ray could clearly record such a fracture. It is worth noting that a marching foot is always.

The most popular way to diagnose a march fracture is palpation. If pressure on the bases of the metatarsal bones brings sharp pain, and also swelling of the soft tissues is clearly visible at the site of the supposed fracture, then the diagnosis is obvious - it is a marching foot. A fresh fracture can also be detected using magnetic resonance imaging. Using special X-ray modes, the specialist notices the vacuum bone tissue, which means there is a gap in the metatarsal bones of the foot.

Foot massage for a marching fracture

Fractures of the metatarsal bones of the foot do not require reduction, unlike many other bones in the human body. Therefore, to treat a march fracture, you do not need to wear an immobilizing cast, and the recovery period will take much less time. Although pressure on the forefoot should be limited, and immediately after recovery, the type of activity that caused the stress fracture should be avoided for a while. Orthopedists recommend using special orthopedic insoles; they will relieve broken bones and make it easier to endure the disease.

And special pain-relieving gels, creams and ointments, which should be applied to the sore spot several times a day, will help cope with swelling, pain and inflammation.

We would like to offer you to watch a video about how you can massage the foot with a cruising fracture.

The prognosis for marching fractures is favorable and often does not have any consequences for the health of the victim. After a complete recovery, a person can completely immerse himself in work, his personal life and hobbies.

- This pathological change structure of the metatarsal bones, resulting from excessive loads. It develops in soldiers, especially at the beginning of their service, as well as after intensive drill training, marches and cross-country races. It may occur in people whose profession requires constant standing, carrying heavy objects, or prolonged walking. Predisposing factors are flat feet and wearing uncomfortable tight shoes. It manifests itself as pain in the foot area, sometimes sharp and unbearable. The pain intensifies with exercise and is accompanied by local swelling of the foot. The diagnosis is confirmed by radiography. Treatment is conservative, the prognosis is favorable.

ICD-10

M84.4 Pathological fractures not elsewhere classified

General information

Marching foot (recruit disease, marching fracture, Deutschlander's disease) is a disease caused by pathological restructuring of the metatarsal bones due to excessive load. It can occur acutely or chronically, but more often it has a primary chronic course. It is treated conservatively, carried out by specialists in the field of traumatology and orthopedics, and ends with complete recovery.

Causes

Marching foot is observed in soldiers, athletes and people whose profession involves long walking, standing or carrying heavy objects. The likelihood of development increases with the use of uncomfortable shoes and flat feet. According to studies conducted in different countries, people with low level familiar physical activity. It is believed that this is due to lower bone strength. It is no coincidence that another category of such patients today is increasingly becoming tourists - office workers who, during their vacation, actively “run” around tourist attractions in uncomfortable shoes.

Pathogenesis

In Deichlander's disease, changes occur in the middle (diaphyseal) part of the metatarsal bones. Pathological reorganization of bone tissue in in this case due to changed mechanical and static-dynamic factors. The process most often involves the second metatarsal bone, less often the third, and even less often the fourth and fifth. This distribution is due to the characteristics of the load on the foot when standing and walking, since in such cases the inner and middle parts of the foot are “loaded” more. The first metatarsal bone is never affected. This is probably due to her more high density and strength.

Usually one bone is affected, although it is possible for several bones in one or both feet to be affected simultaneously or sequentially. It has been established that the marching foot is special kind transformation of bone tissue not associated with tumor or inflammation.

At the same time, the views of specialists on the nature of the damage are still divided. Some believe that bone remodeling is accompanied by an incomplete fracture or a so-called “microfracture.” Others believe that the term “marching fracture” should be considered outdated and untrue, since only local resorption of bone tissue occurs, which is subsequently replaced by normal bone without the formation of a callus.

Marching foot symptoms

There are two clinical forms diseases: acute and primary chronic. The first is observed less frequently and develops 2-4 days after significant overexertion (for example, a long forced march). The second arises gradually, gradually. Its symptoms are less pronounced. There is no history of acute trauma to marching foot. Patients with this diagnosis complain of intense, sometimes unbearable pain in the midfoot.

Lameness appears, gait becomes uncertain, patients try to spare the injured limb. Upon examination, local swelling is detected over the middle part of the metatarsal bone and a denser swelling in the affected area. Skin sensitivity in this area increases. Hyperemia (redness of the skin) is observed quite rarely and is never pronounced. Patients also never experience general symptoms: there is no increase in body temperature, no change in the biochemical or morphological picture of the blood. The pain may persist for several weeks or even months. Average term illness – 3-4 months. The disease ends with complete recovery.

Diagnostics

The diagnosis is made based on a survey, examination and X-ray data. Of decisive importance in this case is the picture obtained during x-ray examination. With Deichlander's disease, a change is detected in the area of the diaphysis of the affected metatarsal bone (sometimes closer to the head, sometimes to the base, depending on the location of the most functionally overloaded area). structural drawing. An oblique or transverse band of clearing (Looser's clearing zone) is determined - the area of bone restructuring. It looks as if the metatarsal bone is divided into two fragments. However, unlike the X-ray picture of a fracture, no displacement is observed in this case.

Subsequently, periosteal growths appear around the affected part of the bone. At first they are thin and tender, then dense, similar to a fusiform callus. Later, the clearing zone disappears and sclerosis occurs. Over time, the periosteal layers dissolve. In this case, the bone remains thickened and compacted forever. The defining features are the absence acute injury, typical localization of damage, as well as the presence of a zone of restructuring in the absence of displacement of fragments and maintaining the correct shape of the bone. It should be borne in mind that during the first few days or weeks there may be no radiological signs of the disease. Therefore, when characteristic symptoms Sometimes it is necessary to take several radiographs at a certain time interval.

Treatment of marching foot

Traumatologists provide therapy. Treatment is strictly conservative; surgical interventions are contraindicated. In the acute form, the patient is given a plaster splint and prescribed bed rest for 7-10 days. After the acute manifestations of the disease subside, as well as in the primary chronic form of the disease, massage and thermal (paraffin baths, baths) and other physiotherapeutic procedures are prescribed. Subsequently, patients are recommended to use insoles and avoid long walks.

Prognosis and prevention

The prognosis is favorable, with the elimination of stress and adequate conservative therapy all symptoms disappear within 3-4 months. Prevention consists of choosing comfortable shoes, choosing reasonable physical activity and careful medical monitoring of recruits.

Marching foot (Deichlander's disease) is a disease that occurs as a result of excessive stress on the metatarsal bones. The pathology mainly affects people with low activity who decide to perform excessive physical work. An unprepared body malfunctions.

The pathology is not inflammatory or malignant. Marching fracture of the foot (code M84.4 according to ICD-10) can occur acutely or chronically.

The pathogenesis of the disease is associated with excessive stress on the legs. The human feet are responsible for support and shock absorption during movement. In untrained people, the bones cannot cope with an unusual load. Pathological changes are formed in the diaphyseal part of the metatarsus. The process may involve the II, III, rarely - IV, V metatarsal bones.

Pathological changes in bone tissue are represented by lacunar resorption. Over time, the affected area is replaced by new cells. The pathological process disappears.

The opinion of professors of medicine on the name of pathological changes is divided. Some believe that an incomplete fracture is formed. Others call the changes a microfracture. Most doctors agree that the name “marching fracture” is outdated. Bone resorption occurs locally, and over time it is independently replaced by bone tissue without complications. The disease is less common among soldiers. Widely distributed among hairdressers and fashion models. They wear huge heels and are on the move all day.

Causes and symptoms of marching foot

Pathological reorganization of bones in Deichlander's disease occurs under the influence of provoking factors.

According to medical statistics, common causes of the disease are:

strong physical activity ensures the development of pathology in untrained people;
walking long distances in uncomfortable shoes;
lack of physical fitness;
pathology occurs in recruits after a field march, or less often a drill march;
congenital/acquired deformities of the foot can provoke the development of a marching fracture.

The risk group for developing the disease includes people in the following professions:

salespeople, consultants in hypermarkets;
stylists, hairdressers;
tour guides;
general workers;
models, athletes;
health workers;
waiters;
figure skaters.

Tight shoes on high heels, the presence of flat feet, walking long distances provoke the development of a marching foot.

According to international classification, there are two forms of pathology:

Acute - characterized by a sudden onset. On days 3-4 we observe the appearance of the first symptoms of marching foot. Patients complain about sharp pain in the middle of the foot, pronounced swelling in the area of pathology. The disease is not accompanied by fever or asthenovegetative syndrome (weakness, loss of appetite).
The primary chronic form of marching foot is characterized by a slow progression. After significant exertion, patients report intense pain in the central part of the sole, swelling, swelling, and redness. The sensitivity of the skin at the site of the lesion increases. Due to the pronounced pain syndrome gait is disturbed. The man begins to limp. The disease lasts for several months, then gradually the symptoms disappear.

Diagnostics

The diagnosis is made based on:

The patient complains of pain with a specific localization.
History of the disease: the first symptoms of the pathology appeared against the background of an unusual load.
Life history (the patient works in an area with intense physical activity on the legs).
Objective examination of the site of injury: upon palpation of the midfoot, the patient complains of sharp pain. On examination, swelling, swelling, and redness are observed.
An x-ray of the foot helps to definitively confirm the diagnosis. The research method reveals typical signs of Deuchelder's disease, excludes osteomyelitis, tuberculosis, malignant tumor, purulent processes of the bone.

The X-ray picture depends on the duration of the disease. Main manifestations of pathology:

If the picture is taken a few days after the onset of the disease, pathological changes may not be observed. It is recommended to repeat the study in a week. Alternative option- do an MRI.
With a marching fracture, an oblique or transverse band of clearing is observed. The phenomenon is called the Looser zone. The metatarsal appears to be split into two pieces. If a person breaks a bone, there is deformation and displacement. The disease does not have the listed phenomena.
Over time, periosteal growths appear around the pathological area. They are represented by thin formations and begin to gradually become denser. The photo resembles a fusiform callus. After a few weeks, the clearing zone completely disappears. Sclerosis of the affected area occurs.
Periosteal layers dissolve. The structure of the metatarsal bone is permanently changed. Becomes thick and dense.

Radiography helps distinguish a march fracture from other traumatic injuries. With pathology, the correct shape of the metatarsus is maintained, there is no displacement of fragments, or an area of inflammation.

Treatment methods

Treatment of marching foot begins with diagnostic measures (X-ray, MRI). After confirmation of the diagnosis, conservative therapy is started:

Doctors prescribe bed rest to the patient.
It is prohibited to put intense stress on the legs. You cannot stand or walk for a long time.
Plaster splints are fitted to restore the integrity of the feet.
The patient must go to therapeutic exercises, massage.
Physiotherapy is prescribed to relieve typical symptoms of the disease.
Apply medications to reduce the manifestations of pain. Painkillers, cooling ointments, and topical balms are prescribed.
You should wear orthopedic shoes and special insoles for a long time to prevent complications.

Surgical methods of treatment for pathology are not used. The microfracture heals on its own.

Contacting traumatology

The disease is being treated in the traumatology department. In acute cases, traumatologists apply a plaster splint for 10 days. The medical device helps restore the physiological structure of the bone. The splint provides rest to the affected limbs.

Primary chronic marching foot is treated with massages and physiotherapy.

IN inpatient conditions To relieve pain, the patient is prescribed:

Ketorolac fights pain and inflammation. The medicine inhibits the activity of COX-1, COX-2. The latter are responsible for the synthesis of prostaglandins. Inflammatory mediators are not formed and unpleasant symptoms disappear. Ketorolac does not affect sleep and breathing, and copes with pain better than many NSAIDs. Prescribed 10 mg up to 4 times a day. The drug is taken under the supervision of a doctor.
Metamizole sodium (analgin) has similar actions. Used to relieve pain of various origins. The medicine should be taken 1-2 tablets 2-3 times a day after meals.
Additionally, calcium supplements are prescribed. The macroelement helps to quickly strengthen the metatarsal bone.

After discharge, the patient should use orthopedic shoes and avoid excessive stress.

Physiotherapy and massage

In case of pathology, doctors prescribe long courses of massage to patients. The technique helps to relax tense muscles of the legs and feet. Thanks to massage movements, blood circulation in the structures of the musculoskeletal system improves, active/passive movements in the joints are restored.

After 2-3 procedures, patients note a decrease in the severity of pain. The methods and techniques of manipulation are determined by the individual condition of the patient. Therapeutic, segmental reflex massage is used. Doctors recommend continuing the procedure at home after discharge from the hospital for 3-6 months.

Physiotherapeutic methods are used to treat Deichlander's disease. Positive dynamics are observed when using electrophoresis, magnetic therapy, paraffin baths, and ozokerite. The procedures improve blood circulation at the site of pathology and enhance regeneration processes.

Home remedies

Traditional methods of treatment are used in complex treatment fractures, bruises, and other limb injuries. Home recipes speed up the healing of injuries and relieve pain. Below are several effective tinctures to combat the disease:

Representatives traditional medicine It is recommended to eat 2 daily walnuts to strengthen joints.
The eggshell film, ground into powder, contains a lot nutrients. Improves the functioning of the musculoskeletal system, internal organs. The medicinal drug is taken together with lemon juice. Course of treatment - until improvement general condition sick.
Make medicinal compresses with ½ tsp salt and raw yolk. Mix the two ingredients and place on a napkin. Apply to the pathological area. Secure with a bandage. Walk around with the bandage all day. Apply compresses until the pain disappears.

Possible complications

In most cases it goes away without leaving a trace. Sometimes complications develop. Delayed treatment the disease leads to serious consequences:

hypertrophic changes in bones;
involvement in pathological process nerves, which is manifested by severe pain;
limitation of movements in the foot;
the appearance of osteoporosis. Pathology leads to frequent fractures;
erysipelas purulent inflammation appears on the marching foot when bacterial flora enters the lesion. Typical signs of erysipelas appear (painful redness, heat body). After the trauma hospital, the patient ends up in infectious diseases department for the treatment of erysipelas;
inflammatory changes in bones can spread to ligaments and tendons. Tenosynovitis develops;
ulcers appear when the integrity of the skin in the area of pathology is violated. Treatment of complications is carried out with antibacterial ointments.

Squeezing out pus on your own is strictly prohibited!

Marching foot is a pathological condition that appears as a result of excessive stress on the feet. Soldiers, tour guides, athletes, and hairdressers get sick.

A disease that occurs as a result of heavy physical stress on the foot, associated with a change or pathology in the structure of the metatarsal bones, is called a march fracture or Deichlander's disease.

Marching foot often appears in people who habitually have low activity, but due to circumstances decide to perform heavy physical activity. It mainly develops on the 2nd metatarsal bone and has a favorable prognosis for recovery.

Distinguish chronic form manifestations or primary acute, associated with exposure to traumatic factors.

Symptoms

A person feels:

when walking, sharp pain in the middle of the foot;
lack of confidence when walking;
lameness lasting several months;
swelling of the feet;
inflammation and tenderness on palpation in the metatarsus area.

March does not have the symptoms that are often found with such injuries - redness, fever, subcutaneous hemorrhages, changes in the blood count.

Causes

A detailed study of the transformations associated with the disease showed the destruction of bone tissue at the affected area and the appearance in their place of new callous-bone formations. Marching foot is a special type of pathological restructuring of bone structures in the metatarsal bones. Sometimes they were considered as hidden fractures, but the concept has no basis, since in most cases the integrity of the bone is not broken and there is no usual contour of the fracture; their destruction occurs from the inside.

There are two reasons for the occurrence of this injury - traumatic, resulting from an impact or strong impact on the area of the foot, and fatigue - acquired as a result of heavy loads.

Diagnostics

If pain occurs in the middle part of the foot, it is necessary to consult a specialist who, using prescribed measures - palpation, visual inspection, patient complaints, research, etc. will determine the diagnosis and prescribe medications that promote rapid healing of bone tissue, eliminating pain and discomfort associated with the injury.

Marching foot is an injury only closed type. It has several stages of development:

on diagnostic equipment a small gap of 1-3 mm in size is visible;
detection of a multilayer structure of bone tissue in the affected area;
noticeable thickening and deformation of tissues;
destruction of layers.

In this regard, if visible symptoms are present, it is necessary to repeat the diagnosis of the injury after a few days.

A march fracture can be diagnosed using MRI. X-ray examination will give results only after 4-6 weeks of the beginning of the destruction process, at initial stage Only some thinning of the tissue is noticeable.

There are no special treatment methods, because the formation of callus at the site of the affected areas of any bones of the foot or skeleton is a normal natural phenomenon. The formation of a callus is a process of healing and fusion of a marching fracture of the foot. An important recommendation is rest and the absence of excessive loads on the leg, as well as the exclusion of activities that lead to the occurrence of a fatigue fracture of bone tissue.

The list of professions with common metatarsal pathologies includes:

there are military personnel, recruits for whom unusual loads suddenly appeared;
athletes are usually present;
those whose activities involve long walking, as well as lifting and carrying heavy loads
hairdressers, surgeons, salesmen, their work requires long periods of standing;
lovers of active recreation and rare but long walks;
ladies who, regardless of their type of activity, wear high heels.

The likelihood of manifestation is also due to the use of small and uncomfortable shoes, or the presence of flat feet.

First aid

When the first symptoms of injury appear after exercise, you need to:

fix the foot with a splint; its role can be played by a board wrapped in clean cloth or gauze;
apply cold to the swollen area for 20 minutes;
give the victim a pain reliever;
put to bed and ensure peace.

Treatment

An uncomplicated marching fracture does not require immobilization of the limb or the application of a plaster cast, and special orthopedic insoles recommended by a specialist can cure the injury and relieve pressure from the injured limb.

When treating marching foot, doctors use a conservative approach. The patient is advised to rest, traditional methods physical therapy, massage of the injured limb.

Procedures that help eliminate pain and swelling in the area of injury are carried out using special creams, ointments, gels, folk remedies. Doctors do not recommend warm compresses or treatments. This interferes with the natural healing of the injury.

The absence of serious consequences of a march fracture has a beneficial effect on the overall picture of the patient’s recovery. After some time (3-4 months), the patient can begin his usual activities and will not feel discomfort and pain during usual physical activity.

In the presence of acute form the patient is given a plaster splint, which can protect against instinctive or accidental movements of the injured limb and avoid displacements and disturbances during the healing process.

Prevention

To avoid serious consequences of injury, it is necessary to adhere to precautionary rules, and this is easier to do if you follow the preventive measures recommended by your doctor:

marching foot requires precise and timely diagnosis a specialist; if problems arise, consult a doctor;
Comfort in wearing shoes and matching the size are important;
exclude long hiking trips that are unusual for you;
serious attitude towards medical examinations that can identify the problem;
recommendations from an orthopedist when choosing a profession, based on the performance of the body and the condition of the patient’s bone tissue.

Consequences

If treatment is refused, the consequences of injury may occur:

foot deformity;
risk of arthrosis;
with an incorrectly fused limb – pain with prolonged exertion;
limited movement of the foot.

In cases of correct and qualified treatment, the prognosis is favorable and is not complicated by serious consequences. The patient will soon be able to return to his usual hobbies and activities.

Due to excessive stress on the lower extremities, some people may develop a pathology called marching foot. In the medical reference book, this disease is also listed as march fracture or Deichlander's disease. It is also called a disease of recruits who are not accustomed to daily forced marches.

There is a pathological change in the structure of the metatarsal bones.

In addition to professional predisposition (young soldiers at the beginning of their service, people whose occupation involves constant standing, long walking or carrying heavy loads), this pathology can be a consequence of flat feet or prolonged wearing of uncomfortable shoes.

Reasons for the development of pathology

There are several risk groups who, due to their constant activity, may experience this structural change in their feet.

New conscripts.

Young people find themselves in unusual conditions:

uncomfortable shoes;
excessive physical activity caused by daily long-term training (running, forced marches, strength exercises).

These conditions adversely affect the condition of the thin, very vulnerable bones of the foot. Prolonged and excessive pressure can cause a fracture. The 2nd metatarsal bone is most susceptible to change; sometimes the marching foot involves the 3rd and 4th. Fractures of the 1st and 5th metatarsal bones are much less common. Please note that the pathology is even named after this group “marching”, that is, because of the grueling marches.

Professionals and lovers of tourist recreation.

Here, too, long treks over rough terrain, especially mountainous ones, cannot be avoided. Lower limbs Not only must they withstand body weight, but also cope with additional loads (a backpack with equipment, ascents and descents).

True, tourists are not only vacationers in the lap of nature. Fans of exciting tourist trips with sightseeing can also become victims of the development of pathology. This is especially true for women who prefer to wear shoes with heels. Under no circumstances should you wear such shoes; for long walks you should purchase comfortable, loose, soft, flat shoes.

There is a high risk of breaking the thin bones of the foot
among professional athletes

There is a high risk of getting a fracture of the thin bones of the foot during grueling training in preparation for competitions. Pathology can develop in athletes who have not exercised for some time and then returned to action. Sometimes the reason may be a change in the model of sports shoes.

Permanent employment

At risk are occupations that require long periods of standing:

hairdressers;
sellers;
bartenders, waiters, cooks;
movers;
guides;
medical workers;
fashion models;
couriers and so on.

The marching foot is provoked by:

flat feet;
unpreparedness of the body for stress;
uncomfortable shoes.

It is considered exclusively as a pathological restructuring of the diaphyseal bone tissue, developing against the background of changed external factors and under the influence of constant functional overload of the foot. The pathology should not be considered as inflammatory or oncological.

Symptoms

The first sign of a disorder is pain. It can be acute or primary chronic, in the first case it is bright pronounced symptom, in the second – less pronounced:

Acute: appears a few days after overexertion (less common);
Primary chronic: increasing, developing gradually.

When a march fracture occurs, pain appears
sensation in the midfoot

Painful sensations appear in the midfoot, sometimes unbearable and intense. As a result, a person tries to put less stress on the injured limb, the gait changes, and lameness appears.

Among the visible symptoms, we note the formation of swelling of the foot in the area of the metatarsal bones of varying intensity: where the fracture is, the swelling is denser.

In the affected area there is increased sensitivity skin. Changes in skin color (redness) are very rare.

The marching form of the fracture is not characterized by the symptoms that accompany most bone fractures: elevated temperature, changes in blood composition, open form.

Diagnostics

Pain and swelling, like obvious signs disorders require mandatory contact with a medical institution to find out the causes, make a diagnosis and, of course, prescribe therapy to get rid of the disorder.

Marching is always closed fracture. However, a traditional X-ray may not be enough because the image will not show the characteristic fracture lines.

Violation of the integrity of bone tissue occurs internally, while the surface of the bone remains seemingly untouched (the fragments remain connected by a thin layer of bone tissue). A clear identification of a march-type fracture using x-rays can be discerned only after a month and a half.

When the radiograph is inconclusive, palpation is used. If, when palpating the affected area, the patient feels a sharp pain, if characteristic swelling of the middle part of the foot is observed, then the diagnosis is obvious.

An MRI is also prescribed to diagnose a metatarsal fracture. The study is especially effective for fresh ruptures.

We also note that the pathological change in the structure of the metatarsal bones has several phases:

Observed initial signs restructuring of the structure of the diaphysis and the surrounding periosteum. In a cross section or slightly obliquely, a homogeneous clearing 1-3 mm wide is visible. A periosteal bone callus is formed around the diaphysis in the clearing zone (locally or involving the entire diaphysis).
Strengthening of periosteal layers, acquisition of bone structure with pronounced signs layering. Dense layers are less visible on x-rays.
The radiolucency is not visible on the radiograph due to excessive periosteal layering. The diaphysis thickens and becomes deformed, especially in the zone of restructuring. Painful sensations are smoothed out.
Gradual resorption of periosteal layers, the structure of the diaphysis is restored. In the image, the diaphysis appears thickened, but clear and with smooth edges.

Therapeutic effect

It is not difficult to treat a march type fracture. Conservative methods are used:

During the treatment period, the patient is provided with conditions for maximum limb rest;
applying a plaster cast for at least a month;
physiotherapy;
massage;
orthopedic shoes or orthopedic insoles for shoes;
local medications (ointments, gels) for pain relief and to relieve swelling.

If the treatment rules are followed, patients can fully recover and return to their normal lifestyle.

Marching feet is not a fatal disease, but this disorder can bring discomfort to everyday life. You need to monitor the quality of shoes, do not overdo it physical activity, and if signs appear pathological condition do not hesitate to contact a specialist.