1. Welcome to the Foot Health Forum community where you can ask about foot problems and get help, as well as be up-to-date with the latest foot health information. Only registered members can ask a question, but you do not need to register to respond and give help. Please become part of the community (here) and check out the shop.

advise needed for a 2nd metatarsal base fracture with lateral cuneiform damage

Discussion in 'Ask your questions here' started by cp83, Oct 30, 2009.

  1. cp83

    cp83 Guest


    Members do not see these Ads. Sign Up.
    In August, I managed to hurt my left foot while non-weightbearing to heal a stress fracture in my left hip. I was 4 weeks into non-weighbearing when it happened. I was staying at my father's and went to bed. The bed was pretty huge (and I am 5'1 and about 110 lbs) and the bedding was tucked in tight all around the bed. I was sleeping on my back (so as not to stress my hip) with my foot straight up. Since the bedding was so tight, the sheets held my foot bent back when I fell asleep. Not sure what I did in my sleep exactly but I woke up in the middle of the night with this intense cramp like pain in my foot. I tried to massage it out but it just made it worse. The pain lasted for 5-10 minutes before subsiding and I went to bed. The remaining 2 weeks on crutches my foot on top would hurt went I bent it up. Once I was give the go ahead to walk again, I felt a sharp pain on top of my foot everytime I stepped off of it. I went back to the doctor after 2-3 more weeks of the pain not getting better. She sent me for x-rays which did not show anything and told me to come back in 3 weeks. I didn't want to wait that because at that point I was a month with pain so I went back to her the next week and she sent me for an MRI. I asked her to make sure they rule out lisfranc injury just in case. I had the MRI on 10/2. The results were:
    1. subacute osteochondral injury & small incomplete nondisplaced fracture (3mm linear low signal focus) at the base of the second metatarsal with moderate associated marrow edema extending into the proximal shaft
    2. small subacute osteochondral injury head of lateral cuneiform
    3. mild generalized narrowing of second tarsal metatarsal cartilage space
    4. no injury to the lisfranc or other intertarsal or tarsometatarsal ligaments
    My doctor referred me to a podiatrist and told me to get a battery of tests done to find out why I fractured another bone. The podiatrist did weightbearing x-rays but he said that my spacing between the joints looked fine. X-rays didn't show the fracture either. He said that I didn't have a lisfranc injury. He told me to use my crutches, wear a cam walker, and use a bone stimulator. I went non-weightbearing again for 3 weeks. At my followup, the podiatrist manipulated my foot and did more x-rays. No pain when he manipulated it and, again, the x-rays didn't show the fracture or joint spacing issues. Based on that he told me that I could go back into a sneaker but to limit my walking. I've been walking for several days now and I still feel a sharp pain right above my second metatarsal when I step off or lean forward. The pain is at the shaft though, not the base. I felt this same pain when I first started walking after my hip injury. It did go somewhat away but I was also taking 2 celebrex because I had inflammation in my hip. Other details are I'm 25 and, up until June, I used to run and play soccer. My questions are is this pain normal? Is 3 weeks long enough for the bone to be adequately healed enough for me to start walking on it? Should I have been casted instead of just given a cam walker? What is an osteochondral injury? Finally, is it possible that I could still have a lisfranc injury even though non-weightbearing x-rays don't show one and the MRI said there was no ligament damage or dislocation/subluxation? Sorry for the novel but I have a tendency to be detail orientated.
     
  2. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    It should be obvious that no one on the Internet could possibly diagnose your problem, much less responsibly comment upon the adequacy of your treatment, but I think it nonsense, unless you have some REALLY serious bone pathology to suggest that the findings that were revealed by the MRI were caused while you were sleeping and just because your sheets were too tight.
     
    Last edited: Oct 30, 2009
  3. Unregistered

    Unregistered Guest

    I know it seems off the wall that I fractured my foot sleeping. It was suggested that it is common for bones to weaken while non-weightbearing and I am still waiting for the results of my bone density test to see if I am osteopenic. Femoral neck stress fractures aren't common either. I didn't have this pain above my second metatarsal before I went on crutches. All I have is the intense pain that woke me in the middle of the night and that is when I started have problems with my foot. It might have bent too far back or twisted in my sleep...I'm not sure what happened exactly. I was very surprised with the what the MRI found. I agree that a responsible diagnosis can't be made over the internet and I'm certainly not hinging on an internet forum for an accurate diagnosis. I'm just looking for information since there is not much available on 2nd metatarsal base fractures that aren't stress fractures and don't involve lisfranc injuries. Eitherway, I made an appt to see a orthopedic foot and ankle specialist on Monday to discuss my injury and receive a 2nd opinion on my treatment.
     
Loading...

Share This Page