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5th metatarsal avulsion fracture

Discussion in 'Ask your questions here' started by Sierra, Mar 25, 2011.

  1. Sierra

    Sierra Guest


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    Hi there.
    One week ago I stepped off a small drop-off in the dark, rolled my ankle, and fractured my 5th metatarsal. It was excruciatingly painful, and I couldn't put any weight on it. I iced and elevated it that night, and went to a walk-in minor emergency clinic the next day. X-rays revealed a complete fracture across the tuberosity of the 5th metatarsal- it's perpendicular to the shaft- I think this is called transverse? Anyway, the broken-off piece of bone was still, for the most part, in the right position. from one angle it looked flawlessly lined up with the rest of the bone, and from another angle it looked ever so slightly shifted out of line, less than 1mm. The doctor said it was a "good break" that should not require surgical intervention.

    I was given a walking boot, which the nurse told me I could begin to walk with immediately. I found this impossibly painful so I procured a pair of crutches from a friend. I still have not tried to fully stand on the foot and it has been one week since I broke it; I've been relying solely on the crutches. Also, I have been wearing the boot when I'm up and about, but taking it off while sitting or lying down.

    My question is this: is it usually recommended to weight bear on a 5th metatarsal avulsion fracture so soon after the break?

    I feel like the doctor and nurses at the walk in clinic I went to, while very empathetic and kind, did not specialize in feet or bones. One reason I think this: the night I broke my foot I had already guessed it was the 5th metatarsal, and had read briefly about the two common types of fractures of that bone- Jones and avulsion. When the doctor was going over my x rays with me, he pointed out the 5th metatarsal fracture, and I said, "oh! It's fractured at the very end. What's that type of fracture called again?" and he shrugged and said "The end?" He never labeled it as a Jones or an avulsion. That exchange and also the fact that the nurse asked me to immediately walk in the walking boot (from reading about the experiences others have had, that seems unusually soon) made me feel like I should seek second and third opinions..

    Ideally I would like to make an appointment with someone specialized; however, I have no health insurance and not much money either. I'm guessing if I only had one shot (money-wise) at seeing an orthopedist, I should save it for a few weeks down the road, when there might be evidence of the bone healing?

    In the meantime, can anyone point me in the right direction on whether or not I should try weight bearing in the walking boot, or if I might be hindering the healing process by doing so? Also, how long would it be best to wait before making an appointment with an orthopedist, if theoretically I could only afford to do so once? Any tips or shared similar experiences would be greatly appreciated. Thanks so much for reading! First broken bone, just trying to read a lot and take care of it correctly.
     
  2. Gimpy Girl

    Gimpy Girl Guest

    The advice you were given is totally consistent with a break at the base of the 5th met (non-Jones fracture). However, it's not that you HAVE to walk on it, the usual instructions are "weight bearing as tolerated". If it's too painful, don't weight bear! A bone has just been broken, you aren't going to make it worse by putting weight on it (within reason), but it's going to hurt. I know when I tried to at the beginning, it would BURN like mad.

    I broke the base of my 5th met all the way across into the joint, and was told to non-weightbear for one week as it was iffy if I'd need a pin. (It was displaced 4 mm). After that week, I was told to weightbear as tolerated, but like you, I couldn't tolerate it, so didn't actually start putting any real weight on it until sometime in the 4th week.

    Just listen to your body.

    My concern though is that you said it went straight across. Did it go into a joint? (intra-articular) If it goes into the joint, you may get traumatic arthritis, and there are issues if it goes into the joint between the 5th and 4th met I understand. Mine went into the joint between the 5th met and the cuboid, and I now have traumatic arthritis as well. No real symptoms from that, but I will eventually I'm sure.

    Anything else I can help with, just ask!
     
  3. Sierra

    Sierra Guest

    Hey, thanks so much for the reply.

    I'm fairly sure the break is limited to the tuberosity of the 5th met, and does not extend into the joint, thankfully!

    Sorry to hear that yours did- so it healed well otherwise? How long did it take to be fully mended? At this point, can you run/jump on it?

    Thanks again for your advice and story, both are reassuring.
    Sierra
     
  4. Gimpy Girl

    Gimpy Girl Guest

    I just found out that my break went into the joint as the original radiologist report on the x-ray said it looked like it didn't. My break took 11 weeks to heal, and perhaps it had to do with going into the joint as I read somewhere that the joint fluid slows healing. Not sure if that's what took so long in my case, but it is now healed totally. I do have traumatic arthritis though (significant the CT scan said), and am still not mobile because of peroneal tendons issues, and perhaps ligament issues as well. I am having an MRI next week I believe so hopefully will find out what's what there.

    I am hoping you are healing well and quickly, and you will be walking normally by 7-8 weeks, even earlier if possible!
     
  5. Sierra

    Sierra Guest

    Thanks!

    Hope the MRI was useful...and that you're back on your feet asap as well.

    Have you, or has anyone else, found any good exercises you can do while waiting for it to heal? I'm really looking forward to swimming, but haven't tried yet- the idea of trying to get to the water on crutches sounds tricky. I've pretty much had no exercise in two weeks, aside from crutching around a little each day, and some light stretching. Argh.

    I guess it's a good opportunity to exercise your patience. :)
     
  6. Gimpy Girl

    Gimpy Girl Guest

    We can't post links on here, but if you do a search for "exercises while in a cast" or "exercises with a broken foot" you'll find lots.
     
  7. Unregistered

    Unregistered Guest

    Sierra, I would strongly reccomend that you clear ANY excercises with your doctor
     
  8. Gimpy Girl

    Gimpy Girl Guest

    Good idea to clear with your doctor, but the ones I found when doing that search did not involve the foot at all -- they were things like leg raises, etc. -- to keep the rest of your body strong while being unable to do cardio or regular exercise.
     
  9. Sierra

    Sierra Guest

    Hi there,

    don't worry, I won't try anything crazy. I still can't put any weight on the foot at all...I was just wondering about leg strengthening stuff that doesn't involve the foot.

    Speaking of not putting any weight on it...I'm concerned that it's been 2 weeks and I still can't walk at all in the walking boot. It seems like most people are able to, so I wonder if I have other undiagnosed injuries (to tendons/muscles) that could be causing this? Hmm. Or perhaps it's just because I haven't taken any painkillers, and most people do?

    On a side note, I realize that a doctor's opinion would be best here. Unfortunately I don't have health insurance and have not been able to afford to see a specialist (or any doctor since the first one at the walk-in clinic.) So, my strategy is just to stay off it and try to treat it as well as I can, (use crutches and use the walking boot..) and hope for the best...while in the meantime talking with others who have had similar injuries, and comparing experiences for reassurance and ideas. Not ideal, I know, but not everyone can afford to see a doctor.

    :)
    Thanks for the advice.
     
  10. Gimpy Girl

    Gimpy Girl Guest

    You'll need a followup at 6 weeks for another x-ray to confirm healing, but it is normal to not be able to put weight on it at first until some healing of the bone takes place. I couldn't put weight on mine until about the 5 week mark, but it was still quite sore as I also have tendon injuries.

    It is quite common to have "collateral damage" and not just the fracture. It takes quite the force for the peroneal tendons to contract enough to break a bone, so they are going to be strained at the least, torn possible, and the ligaments on that side of the ankle are also going to be injured to some degree. They don't really stop you from weight bearing unless it's a very severe sprain/strain, but you may not be able to move your ankle properly. I had trouble walking on mine as my tendon injury goes just below the cuboid bone (where the tendon turns to go under the foot) and was quite inflamed, but it has gotten somewhat better in the 8 weeks since my fracture was deemed healed. Have trouble walking though as that motion inflames the tendons and the entire side of my ankle is swollen and very painful. I'm in a boot at the moment until I get MRI results to see if that helps the tendons calm down.

    You may find, like I have, that the tendons and ligaments take considerably longer to heal than the fracture.
     
  11. ricarleite

    ricarleite New Member

    I'm new to this forum, and I've seen from several posts here that a 5th metatarsal fracture is quite common. I've never heard of it, or at least thought about it, until it happened with me, about 2 and a half weeks ago. I had a cast during the first week, and now I'm on a walking boot. I feel only slight pain very occasionally. It was an avulsion fracture and the bone's on the place. On the X-Ray I could see a very thin line crossing the base of the bone. The doctor said I should be fine 4 weeks after the fracture (half way there, I suppose). Is the prognosis for this sort of fracture really 4 weeks? I've seen 6, 8, 12 weeks, and it really scared me. I need to be off and driving and walking as soon as possible...
     
  12. Unregistered

    Unregistered Guest

    If 4 weeks was the judgement of the doctor who examined and is treating your fracture, why would you think that someone here having never examined you and probably not a doctor could give you any more reliable information? Express your concerns to your doctor and ask what he based his estimate on.
     
  13. ricarleite

    ricarleite New Member

    Well, I was not asking for people to give advice on my specific case, I just wanted to see what people who have passed through similar cases have gone through. I know a diagnosis is not possible, I am not an idiot. I was looking for some similar cases, that is all.

    I've seen other posts on this forum and I noticed this sort of bad-tempered arrogance is somewhat common. This is a bad environment for a internet community. Since I expect no positive feedback, I tend to suggest to other possible future users to avoid this forum.
     
  14. Gimpy Girl

    Gimpy Girl Guest

    The doctor most likely said 4 weeks because there was no gap in the fracture. Your fracture won't be healed at 4 weeks, it'll just be healed enough to walk without a cast on. Fractures can take up to 6 months to be invisible on an x-ray.

    As for the rude reply, I had to look twice as I was sure that was FootDoc responding, and I know he's responded to another post "incognito" so I wouldn't be surprised if it was him. Don't let one rude person steer you away from this forum.
     
  15. Scooby Doo

    Scooby Doo Guest

    I agree with the answer you got. If you weren't asking for your own specific case, what's the point? Why would what other people passed through be trusted more than what your doctor told you? He told you to take your doubts to your doctor and get an answer which would apply to you. Can't see what you're griping about.
     
  16. Gimpy Girl

    Gimpy Girl Guest

    I don't think this person was wanting to know if they should or shouldn't be weight bearing at 4 weeks and asking if they should do something different. They were wanting to know if other people started wb at that time for that type of fracture. I know I asked the same types of questions so I could be more informed when I went to my doctor. How else will someone know if what their doctor is proposing is the norm or not unless they ask other people?
     
  17. Scooby Doo

    Scooby Doo Guest

    Certainly not by asking other people who are not doctors and only think they had the same problem and gives advice based on what they had done without even knowing if that was the norm.
     
  18. Gimpy Girl

    Gimpy Girl Guest

    I think FootDoc and others assume that because someone asks a question and someone answers with "I had my cast on for 6 weeks" that the person is going to throw away the boot or cast and go on the merry way without checking with a doctor. People aren't idiots (well, not most of them anyway). I have used these forums the same way I suspect countelss others have -- to use them as a benchmark. Is what I'm experiencing something that falls within the experiences of other people? Oh, ok it is, so now I don't have to put in an urgent call to the doctor, it can wait until Monday when I see him next. Oh, it doesn't, no one's ever had this symptom with their foot issue ... I'm calling the doctor immediately...

    And when I answer a question, I do not profess to be a doctor, and encourage people to see their doctor.

    This forum is no different than a group of people sitting around a Starbucks, having their morning coffee, and chatting about some injury one has had. All the others chime in with what happened to their uncle, mother, father, .... The person listens, takes what makes sense, and goes from there.

    I agree there may be a small percentage who will come on here asking if they should be totally weightbearing at 3 weeks or something, and if someone says "I was weightbearing at 3 weeks with a 5th met fracture", the poster will then go ahead and be trying to walk, not realizing the types of fractures are different. HOpefully those types are few and far between.

    Either way, I truly believe in diplomacy on here. No one should be made to feel stupid for asking a question and if it's a question they really need to check with their doctor, there are polite ways of saying it.

    Have a great Wednesday, everyone! And don't be shy about asking questions -- the only dumb question is the question that never got asked! The worst that will happen is that someone will tell you to ask your doctor to be sure.
     
  19. Scooby Doo

    Scooby Doo Guest

    Gimpy Girl, the post that you keep having such mean things to say about only told the person that asked the question and has some concerns about why his doctor told him what he told him to expect that the place to get that explained is from that doctor or another doctor and not from a group of people sitting around at Starbucks drinking coffee. It wasn't mean. It was just good advice. Why can't you see that when you say mean things about people who don't agree with you here that you are no better than what you are complaining about.
     
  20. Gimpy Girl

    Gimpy Girl Guest

    My answers were mean? I just expressed a difference of opinion, and didn't attack anyone specifically or say anything rude. My point was that there is much of "Why would you ask that here?" on this forum (not just this thread), with directions to ask their doctor and nothing else. While the advice to check with the doctor definitely needs to be included, there is no need to chastise or admonish someone for asking a question on an internet forum. People come here for a reason: They're worried, they can't understand what their doctor told them, their doctor's appointment is not immediate, or they want to be sure what their doctor tells them is in line with what other doctors do for their patients. Perfectly reasonable.

    Have a good Wednesday!
     
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