Applying a Cast to a Fractured Metatarsal Bone: A Comprehensive Guide



A fractured metatarsal bone, or a broken small toe bone, is a common injury that can significantly impact mobility and daily activities. To promote proper healing and ensure a successful recovery, it is crucial to correctly apply a cast to the affected area. This article provides a detailed guide on the step-by-step process of applying a cast for a fractured metatarsal bone, along with important considerations and precautions.

1. Understanding the Metatarsal Bone

The metatarsal bones refer to the long bones located in the forefoot. There are five metatarsal bones in each foot, numbered from one to five, starting from the big toe. Fractures in the metatarsal bones commonly occur due to direct trauma, such as dropping a heavy object on the foot or from a sports-related injury.

1.1 Types of Metatarsal Fractures

Metatarsal fractures can be classified into different types based on the location and severity of the fracture. The most common types include:

  • Stress fractures: Hairline cracks in the bone caused by repetitive stress or overuse.
  • Avulsion fractures: When a small piece of bone is pulled away from the main bone due to a tendon or ligament injury.
  • Displaced fractures: Fractures where the broken ends of the bone do not align properly.
  • Non-displaced fractures: Fractures where the broken ends of the bone remain in alignment.

2. Initial Assessment and Diagnosis

Before applying a cast, it is essential to conduct an initial assessment and obtain a proper diagnosis. This is typically done by a healthcare professional or orthopedic specialist. The assessment may involve:

  • Physical examination: Checking for visible signs of swelling, deformity, or tenderness in the affected area.
  • X-ray: Capturing images to determine the location and severity of the fracture.
  • Medical history: Understanding any pre-existing conditions or previous injuries that may affect the treatment plan.

2.1 Consulting a Professional

While it is possible to apply a cast at home, it is strongly recommended to seek professional guidance to ensure proper diagnosis and treatment. An orthopedic specialist can provide accurate assessments, recommend the appropriate type of cast, and monitor the healing process throughout.

3. Preparing for the Casting Procedure

Before applying the cast, it is crucial to gather all the necessary supplies and prepare the patient for the procedure. The following steps should be taken:

  • Ensure a clean and well-lit environment to facilitate the casting process.
  • Gather supplies, including a cast pad, cast tape, scissors, stockinette, casting material (plaster or fiberglass), and a bucket of warm water.
  • Position the patient comfortably, allowing access to the affected foot while maintaining stability.
  • Explain the procedure to the patient, addressing any concerns or questions they may have.

4. Applying the Cast

The casting procedure involves several steps to ensure proper immobilization and support for the fractured metatarsal bone. It is crucial to follow these steps carefully:

4.1 Padding the Affected Area

Before applying the cast material, it is essential to pad the affected area to prevent discomfort and pressure sores. The steps for padding include:

  1. Cover the foot with a stockinette, ensuring it extends beyond the toes and ankle.
  2. Place a cast pad over the fractured area, ensuring it covers the entire surface.
  3. Wrap additional padding around bony prominences or sensitive areas for added protection.

4.2 Preparing the Casting Material

The choice of casting material may vary based on the healthcare professional’s recommendation or the patient’s preference. The two most commonly used materials are plaster and fiberglass:

Plaster Fiberglass
Traditional casting material Lightweight and breathable
Messy application Quick-drying
Requires longer drying time Water-resistant

Regardless of the chosen material, the casting material should be prepared according to the manufacturer’s instructions. This typically involves cutting the material into appropriate lengths and immersing it in warm water for plaster or activating the fiberglass with water.

4.3 Applying the Cast Material

Once the casting material is prepared, it is time to apply it to the fractured metatarsal bone. The steps for applying the cast material include:

  1. Start wrapping the casting material around the foot, beginning at the toes and moving towards the ankle.
  2. Ensure each layer overlaps the previous layer by approximately 50% to provide stability and strength.
  3. Maintain a smooth and even application, avoiding excessive tightness that may hinder blood circulation.
  4. Continue wrapping until the desired thickness and coverage are achieved, typically around 4-6 layers.

5. Caring for the Cast

Once the cast is applied, it is essential to provide proper care and maintenance to ensure optimal healing and prevent complications. The following guidelines should be followed:

  • Elevate the leg to reduce swelling and promote blood circulation.
  • Avoid getting the cast wet to prevent softening and discomfort.
  • Do not insert objects inside the cast, as it can cause irritation or damage to the skin.
  • Report any signs of discomfort, excessive pain, or foul odor to the healthcare professional.

6. FAQs

FAQ 1: How long does it take for a fractured metatarsal bone to heal?

The healing time for a fractured metatarsal bone varies depending on the severity of the fracture and individual factors. On average, it may take approximately 6-8 weeks for a metatarsal bone to heal. However, this timeframe can be longer for more severe fractures or in the presence of underlying medical conditions.

FAQ 2: Can I walk with a cast on my fractured metatarsal bone?

Walking with a cast on a fractured metatarsal bone should be avoided initially to allow proper healing. Depending on the severity of the fracture and medical advice, weight-bearing may gradually be permitted after a few weeks. It is important to follow the healthcare professional’s guidance to prevent further damage or delayed healing.

FAQ 3: How often should I have the cast checked by a healthcare professional?

Regular check-ups with a healthcare professional are essential to monitor the healing progress and ensure the cast remains in optimal condition. Typically, appointments are scheduled every 2-3 weeks, during which the healthcare professional may assess the cast’s fit, make adjustments if necessary, and evaluate the healing process.

FAQ 4: Can I remove the cast by myself once the fracture is healed?

No, the cast should only be removed by a healthcare professional. They have the necessary tools and expertise to safely remove the cast without causing harm or re-injury. Attempting to remove the cast independently can lead to complications or disruptions in the healing process.

FAQ 5: What should I do if the cast becomes itchy or uncomfortable?

If the cast becomes itchy or uncomfortable, it is important to avoid inserting objects inside the cast, as this can damage the skin or cause infection. Instead, gently tapping or blowing cool air into the cast may provide temporary relief. If the discomfort persists or worsens, it is advisable to consult a healthcare professional for further evaluation.

FAQ 6: Can I shower or bathe with a cast on my fractured metatarsal bone?

It is generally recommended to keep the cast dry to prevent softening and discomfort. However, there are waterproof cast covers available that can provide a barrier against water. Consult with a healthcare professional to determine the most appropriate method for keeping the cast dry during bathing or showering.


Applying a cast to a fractured metatarsal bone is a critical step in promoting proper healing and restoring functionality. By understanding the process, seeking professional guidance, and providing appropriate care, individuals can increase the chances of successful recovery. Remember to closely follow the healthcare professional’s instructions and attend regular check-ups to ensure the best possible outcome.

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