Question
(10/10/2011):
Title:
Pain on top of the foot | Pain can be felt from ankle to toes.
Dear
Sir,
Recently
for last one month, I am getting pain on top of the right foot.
Pain
can be felt from right ankle to toes.
It pains
more while I am walking when the toes fingers are bending.
I am
36 years old female -housewife.
There
is no other health problem.
I am
absolutely normal.
Please
advice.
Thanks
& Regards
Answer:
It may
be a stress fracture.
Stress
fractures are injuries from prolonged bone use that usually affects
individuals physically active.
It tends
to occur in the medial metatarsals (90%) and less frequently in the
tarsal navicular.
The most
important complications of this injury include chronic pain and non-union
(fracture areas relatively avascular).
It is
important to rule out other conditions such as posterior tibial tendonitis,
stress fracture of the talus and tarsal tunnel syndrome.
The treatment
of metatarsals fractures consists of rest and use of rigid-soled shoes
for four weeks to prevent the extension of the metatarsals during
walking, and then progressive rehabilitation, in case of displaced
fractures foot should be plastered for four weeks.
Tarsal
navicular fractures occur most often in the sagittal plane in the
central third of bone, causing more insidious pain, located on the
inner side of the midfoot, it radiates to the first or second metatarsal,
and it gets worse with running or jumping and improves with rest.
In both
types of fractures, the clinical history is essential. The fracture
of the metatarsals can be confirmed by radiography (X-rays) of the
foot (visible at 3 weeks). Technetium bone scan is a sensitive but
nonspecific test positive at 24 hours.
The bones
of the feet cannot withstand repeated stresses beyond a threshold
above which microscopic bone cracks may produce that may extend to
form evident fractures.
Repeated
stress causes an imbalance in bone remodeling, so the periosteal resorption
occurs faster than bone formation, resulting in a weak bone cortex
that break to the effort.
It can
be the first manifestation of osteoporosis or osteomalacia.
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