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ORIF Metatarsals Surgery

Open Reduction and Internal Fixation of the metatarsals is a surgical procedure carried out following fracture of the toes (metatarsals). Meta tarsal fractures are usually due to traumatic injury seen mainly within the sporting population involved in high impact sports.

ORIF Metatarsals Surgery Indications

The indication for ORIF metatarsal surgery is significant displacement of metatarsal fracture(s). Surgery is most commonly performed on the 5thmetatarsal as it is the most susceptible to injury.

Soft tissue massage of the planta fascia under the footAbove: Soft tissue massage of the planta fascia under the foot

Signs and symptoms of a metatarsal fracture are:
  • Pain at the fracture site
  • Swelling
  • Discolouration or bruising
  • Difficulty weight bearing through the foot
If you think you have fractured your metatarsal(s) you should get an x-ray. The results of the x-ray will determine the extent of the fracture and the treatment required.

Passive stretch of the connective tissues in the footAbove: Passive stretch of the connective tissues in the foot

ORIF Metatarsals Surgical Procedure

The ORIF metatarsals procedure is as follows:
  • Small incisions are made over the fracture area
  • The fracture is put back into alignment (or ‘reduced’)
  • The bones are kept in alignment with wires, screws or plates and secured together as closely as possible
  • The wound is stitched up and a splint is applied to give some support to the foot
About a week after the surgery you be put in cast. You will be given crutches and instructed not to put any weight on the operated foot for 6 weeks after the surgery. After this you will be given a CAM walker support for the foot and be put on protective weight bearing for a further 6 weeks. Physiotherapy rehabilitation will begin to help you return to normal weight bearing and full function/sport.

Ultrasound electrotherapy applied to the soft tissues of the foot and ankleAbove: Ultrasound electrotherapy applied to the soft tissues of the foot and ankle

The Benefits Post-Surgery

There are many benefits of ORIF metatarsal surgery including the following:
  • Reduced pain
  • Restoration of movement in the foot
  • Increased muscle strength
  • Regaining of balance and proprioception
  • Return of a normal gait pattern
  • Return to normal functional activity
  • Return to sport
Physiotherapy is essential in gaining the above benefits post-surgery.

Friction massage of the ligaments in the footAbove: Friction massage of the ligaments in the foot

Physiotherapy Rehabilitation Post-Surgery

Physiotherapy rehabilitation begins when the cast is removed, about 6-8 weeks after surgery, to aid restoration of movement, strength and function.

Physiotherapy rehabilitation will involve a combination of many treatment techniques including:
  • Swelling management
    When your cast is removed your foot is likely to still be swollen. Ice, elevation and gentle exercises are important for reducing swelling.
  • Gait re-training
    You will begin weight bearing and aim towards regaining full mobility without any walking aids.
  • Range of movement exercises
    Mobility exercises will begin to reduce joint stiffness and muscle tightness, regaining of full range of movement.
  • Strengthening exercises
    Once movement has been regained, resistance exercises will be given to increase the strength of the foot muscles.
  • Sports specific training
    Your physiotherapist will give you a programme of exercises and sports specific drills to get you back to your previous sporting level.

Physiotherapy ensures a safe return to normal daily activity and sport.

If you have had or are due to have ORIF metatarsal surgery, you can book in with our specialist physiotherapists for an assessment. Please e-mail or contact us by calling 0330 088 7800.

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