FOOT STRESS-FRACTURE(March Fracture; Fatigue Fracture)
FOOT STRESS-FRACTURE (March Fracture; Fatigue Fracture)
DESCRIPTIONA foot stress-fracture is a complete or incomplete hairline break in a foot (metatarsal) bone. This type of fracture may look similar to a bone tumor on an X-ray. Stress fractures may not become apparent for several weeks after pain begins in the foot. The metatarsal bones of the foot, the metatarsal joints, and the soft tissue around the fracture site, including muscles, nerves, tendons, ligaments, periosteum (covering of the bone), blood vessels, and connective tissue, are involved.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Physical therapy and rehabilitation.
Self-care during rehabilitation.
SIGNS & SYMPTOMSPain in the foot when the child is walking or running. Pain diminishes or disappears when the load is taken off the child's feet.
Tenderness to the touch in the fracture area.
Fatigue of the child's foot bones caused by repeated overload, as with marching, walking, running, or jogging.
RISK FACTORSWalking, running, jogging, or standing for prolonged periods.
History of bone or joint disease, especially osteoporosis.
Poor nutrition, especially calcium deficiency.
PREVENTING COMPLICATIONS OR RECURRENCEHeed early warnings of an impending stress fracture, such as your child's complaining of foot pain after extended standing or walking. Adjust the child's activities before a fracture occurs. Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk products or calcium supplements.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; X-rays of both feet and ankles (X-rays are often normal for the first 10 to 24 days after symptoms begin); radioactive technetium 99 scan (See Glossary), if symptoms are typical but the child's X-rays are negative.
POSSIBLE COMPLICATIONSComplete fracture from continued stress on the child's foot after symptoms begin; pressure on or injury to nearby nerves, ligaments, tendons, blood vessels, or connective tissues; problems arising from plaster casts, splints, or other immobilizing materials (See Appendix 41, Care of Casts); an unstable or arthritic joint following repeated injury.
The average healing time for this fracture is 6 to 8 weeks with adequate treatment. Healing is considered complete when there is no pain at the fracture site and when X-rays show complete bone union.
HOME CAREYour doctor will probably apply a short, weight-bearing cast to your child's leg. For care of casts See Appendix 41.
MEDICATIONNarcotic or synthetic narcotic pain relievers for severe pain.
Stool softeners to prevent constipation due to inactivity.
Acetaminophen or ibuprofen (available without prescription) for mild pain after initial treatment.
See Medications section for information regarding medicines your doctor may prescribe.
Your doctor may prescribe:
ACTIVITYDon't bear weight on the injured foot. Learn to walk with crutches, and use them through the first week with your walking cast. See Appendix 37 (Safe Use of Crutches). Prop your foot up whenever possible.
Begin reconditioning and rehabilitation exercises as prescribed by your doctor.
Resume normal daily activities gradually after treatment.
Instructions for your child:
DIET & FLUIDS
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has unexplained foot pain.
Your child's toes become dark, blue, cold, or numb while the cast is on.