Brief Outline of Metacarpal Fractures

Breaks or fractures in one or more of the metacarpal bones may result from a variety of events. They are common in football and basketball players. Metacarpals are vulnerable of events. They are common in football and basketball players. Metacarpals are vulnerable to direct force and can be fractured when a closed fist strikes another person or hard object, such injuries being referred to as boxer’s fracture. Metacarpal bones can fracture either at the base, shaft or neck. The most common fracture is of the neck of the fifth metacarpal.

Anatomy and physiology

The five metacarpal bones run between the wrist and the knuckles (which are the heads of the metacarpals). Each metacarpal bone comprises a base, neck and head, (from proximal to distal end). The first metacarpal bone is the shortest and most agile, and connects with the trapezium at the proximal end of the thumb. The other four metacarpals of teh hand connect to the trapezoid, capitate and hamate, and lateral-medial surfaces of metacarpal bones. Each finger has three phalanges, whereas the thumb only has two, making a total of fourteen phalanges. These connect with the heads of the metacarpals, forming the knuckles when the fist is closed.

Metacarpal Fractures

Cause of metacarpal fractures

A direct blow to the hand. Falling directly onto the hand. Longitudinal force transmitted through a closed fist when punching.

Signs and symptoms

Local pain and swelling. Bruising and deformity of the broken bone or knuckle. Loss of hand movement and function in the affected region.

Complications if left unattended

Use of hand not properly immobilised following metacarpal fracture may lead to lasting deformity and reduced function as well as possible damage to surrounding nerves, muscles, tendons, blood vessels, and ligaments.

Call (+65) 6471 2674 to see our hand specialist regarding metacarpal fracture today.

Biceps Femoris Avulsion Fracture

Brief Outline of Biceps Femoris Avulsion Fracture

An avulsion fracture occurs when a tendon or ligament pulls away from the bone at its attachment, pulling a piece of the bone away with it. This usually results from a forceful, twisting muscular contraction or a powerful hyperextension or hyperflexion of the knee. The injury is more prevalent in children than adults: in adults the tendons or ligaments tend to tear before the bone is affected, whereas the softer bones tend to become involved in children’s injuries.

Biceps Femoris Avulsion Fracture

Cause of Biceps Femoris Avulsion Fracture

Forceful twisting, extension, or flexion, causing extra stress on the tendon. Direct impact on the knee, causing forceful stretching of the biceps femoris tendon.

Signs and Symptoms of Biceps Femoris Avulsion Fracture

Pain at the back of the knee. Swelling and tenderness. Loss of hamstring strength and decreased ability to flex the knee.

Complications If Left Biceps Femoris Avulsion Fracture Unattended

When left untreated an avulsion fracture will lead to long-term disability in the hamstrings and knee joint. Incomplete or incorrect healing may result as well, leading to future injuries of the knee and other muscles around the joint.

Immediate Treatment for Biceps Femoris Avulsion Fracture

R.I.C.E. Immobilisation of the knee joint. Anti-inflammatory medicines. Seek immediate medical help.

Rehabilitation and Prevention for Biceps Femoris Avulsion Fracture

Rest for the injured knee and then strengthening the muscles and supporting ligaments will help rehabilitate and prevent future fractures. Gradual re-entry into full activity is important to  prevent re-injuring the weakened area.

Long-term Prognosis and Surgery for Biceps Femoris Avulsion Fracture

With proper treatment most simple avulsion fractures will heal completely with no limitations. In rare cases surgery may be needed to repair the avulsed bone, especially in children when the avulsion involves a growth plate.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our knee specialist regarding your biceps femoris avulsion fracture today.

Immediate Treatment for Tibia / Fibula Fractures

If you have fracture to the tibia or fibula or both, see a doctor immediately as the two bones are weight bearing bones. It will be good not to delay treatment. Immobilise the leg.

Brief Outline of Fractures (Tibia, Fibula)

Most human bones have outer shells of cortical bone, which means that the porosity is low, with cancellous bone underneath (high porosity). The cortical bone means that the structure is stiffer and capable of withstanding great stress. When the outer shell is cracked it is called a fracture. The bone may be either partially fractured or completely broken.

Anatomy and Physiology of Fractures (Tibia, Fibula)

The tibia (shin bone) is the larger and more medial of the bones in the lower leg. At the proximal end the medial and lateral condyles articulate with the distal end of the femur to form the knee joint. The tibial tuberosity is a roughened area on the anterior surface of the tibia. The fibula lies lateral and parallel to the tibia and is thin and sticklike. The fibula is not a weight bearing bone and plays no part in the knee joint, the tibia i the only weight bearing bone of the lower leg. Both bones meet at the ankle. Although either bone can be fractured alone, they are most commonly fractured together. Most fractures involve the proximal (near the knee), or distal (near the ankle) ends of the bone. Due to the thin covering of skin and other tissue over the tibia, these fractures are often open fractures, meaning the broken bone ends break the skin.


Cause of Fractures (Tibia, Fibula)

Direct force (impact) to the bones along the shaft or extreme loading of the bone, such as with a landing from a high fall. Rotational or indirect forces on the bones, e.g. tackle in football. Twisting, especially when the bone is under a load or when the foot is fixed.

Signs and Symptoms (Tibia, Fibula)

Pain, inability to walk or bear weight, and often inability to move the leg. Deformity may be present at the fracture site, or the fracture may be open. Swelling and tenderness.

Complications If Left Tibia / Fibula Fractures Unattended

Instability in the lower leg is one long-term complication of an untreated fracture. Blood vessel damage from a fracture can lead to internal bleeding and swelling as well as circulation problems for the foot. Nerve involvement can lead to serious problems such as drop foot or a loss of sensation in the lower leg and foot.

Rehabilitation and Prevention for Tibia / Fibula Fractures

After the fracture has healed, it will be necessary to rebuild the strength and flexibility of the muscles in the lower leg. Range of motion activities may be needed for the knee and ankle depending on the location of the fracture and the extent of immobilisation required. When the fracture has healed a gradual re-entry into activity must be observed to prevent re-injury. Strong calf and anterior tibialis muscles will help protect the tibia and fibula.

Long-term Prognosis for Tibia / Fibula Fractures

If set properly and allowed to heal fully, a fracture should not present any future problems. In some cases a rod or pins may be needed to hold the bones in place during healing. Surgery may be required in a few cases where blood vessel or nerve damage is severe.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to treat your Tibia / Fibula Fracture today.

Ankle Fracture

Brief Outline of Ankle Fracture

The ankle joint is one of the most commonly injured joints in the body. The majority of athletes have experienced at least a minor sprain of the ankle. Ankle fractures are less common, but nonetheless more common than other fractures. Due to the ankles involvement in all running and jumping activities, it is very susceptible to injury. Running or jumping on uneven or changing surfaces can lead to ankle fractures. High impact sports such as football and rugby, where the possibility of forceful twisting of the ankle may occur, also have a high incidence of ankle fractures.

Anatomy and Physiology of Ankle Fracture

Ankle Fracture

The ankle joint, is a hinge joint, and comprises the tibiafibula, and talus bones. The ankle joint articulates between the distal tibia, the medial malleolus of the tibia, the lateral malleolus of the fibula and the talus. These bones are held together by a series of ligaments. In an ankle fracture, any or all of the bones and ligaments may become involved. Ankle fractures most commonly involve the ends of the tibia or fibula, or both, with some ligament stretching and tearing present as well.

Cause of Ankle Fracture

Forceful twisting or rolling of ankle can cause the end of the bones to fracture. Forceful impact to the medial or lateral side of the ankle while the foot is planted.

Signs and Symptoms of Ankle Fracture

Pain to touch. Swelling and discolouration. Inability to bear weight. Deformity may be present in the ankle joint.

Complication If Left Ankle Fracture Unattended

An ankle fracture that is left unattended can result in incorrect or incomplete healing of the bones. Continued walking or running on the injured ankle could result in further damage to the ligaments, blood vessels, and nerves that pass through the joint.

Immediate Treatment for Ankle Fracture

Stop the activity. Immobilise the joint and apply ice. Seek medical attention.

Rehabilitation and Prevention of Ankle Fracture

While the ankle is immobilised, it is important to keep conditioning levels up by using upper body exercises and weight training. When cleared for the activity with the ankle, strengthening and stretching of the muscles of the lower leg is essential for a speedy recovery. An ankle brace may be needed for support during the initial return to activity. Stronger calf and anterior muscles help support the ankle and prevent or lessen the incidence of injuries. Avoid running and jumping on uneven surfaces as much as possible.

Long-term Prognosis for Ankle Fracture

Although people who have fractured their ankle tend to have a slightly higher rate of re-injury, proper strengthening and rehabilitation usually lead to a full recovery. Compound fractures or those in misalignment may require surgical pinning to hold the bone in place while it heals.

Call (+65) 6471 2674 to fix an appointment to treat your Ankle Fracture today.

Brief Outline of Fracture of the Foot

A foot fracture may involve any of the twenty-six bones of the foot but most commonly occurs in the metatarsals. Contact sports and those that could result in high impact landing or collisions can lead to foot fractures. Those athletes with lower bone density due to poor nutrition, osteoporosis, (or inadequate or absent menstrual cycles in females) are more susceptible to fractures.

Anatomy and Physiology of Fracture of the Foot

Foot Anatomy

The foot consists of twenty-six small bones. The seven tarsals form the ankle. The two largest tarsals carry the body weight: the calcaneus, or the heel bone, and the talus, which lies between the tibia and the calcaneus. The tibia and fibula rest on top of the talus. The five metatarsals are long, narrow bones that form the instep or sole of the foot and the fourteen phalanges consist of short, narrow bones that form the toes, with two joints in the big toe and three in the others. These bones, due to their location and shape, are more susceptible to fracture. When a force is applied to the shaft of the metatarsals, they may fracture.

Cause of Fracture of the Foot

Trauma to bones of the foot, e.g. fall, blow, collision, or violent twisting.

Signs and Symptoms of a Fracture Foot

Pain, which can be severe. Swelling and discolouration, and possible deformity at the fracture site. Pain when weight-bearing, and possible inability to walk. Numbness of the foot or toes.

Complications if Left the Fracture Foot Unattended

A fracture that is left untreated can lead to damage to the blood vessels and nerves in and around the fracture site. The bones may heal incorrectly or not heal at all. Weakness and instability in the foot may result as well.

Immediate Treatment for Fracture Foot

Ice, elevation, and possible immobilisation. Consult an orthopaedic surgeon.

Long-term Prognosis for Fracture Foot

If allowed to heal completely, a fracture will usually heal to become stronger than before the injury. In fractures that are compound or misaligned, surgical pinning may be required to stabilise the bone until it heals. If the ligaments are stretched or torn, the chance of re-injury increases.

Call (+65) 6471 2674 to fix an appointment to treat your Foot Fracture today.