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Avulsion Fracture - 5th Metatarsal

Discussion in 'Ask your questions here' started by amy.elliott4285, Nov 4, 2009.


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    Hi Doc!

    I realize that you're probably a very busy person so I will keep this as brief as I can.

    A little background info - I am a 25y/o female from the US. Health hx includes hypothyroidism (100mcg levothyroxin qd), depression (40mg celexa qd), and a bilateral oopherectomy in 2008. I am also overweight and a smoker, two very big strikes against me.

    4 weeks ago I was coming out of the nurses station in a hurry and rolled my ankle. Dx - right avulsion fracture, 5th metatarsal. I was splinted and non-weight bearing for 9 days. I then met with the orthopedic surgeon who gave me the hard shoe and said I could begin weight bearing as tolerated. I used the crutches with the shoe for about 3 days and have not had to use them since.

    I still have some pain, especially if i stand for more than a few minutes, walk a far distance or walk on uneven ground (gravel, grass, anything but a flat surface). I still have swelling, a bit of bruising and slight numbess in the area of the injury. RICEing the area does seem to help, but I'm tired of being on my ass all of the time. I'm ready to get back to my life.

    My questions:

    I am supposed to take HRT r/t the bilateral oopherectomy. Took it for a few months and stopped. Could the lack of these hormones and/or hypothyroidism affect my healing time in any way?

    How big an effect does my weight (I would be considered "obese") and the fact that I smoke have on healing time?

    I don't go back to the orthopedic surgeon for 2 weeks but I need to get back to work ASAP. I've begun ambulation (only at home) without the hard shoe, but if tolerated, could I try a regular shoe?

    Thanks for your time and I appreciate any insight.

    -Amy
     
  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.
    ***********************************************************
    The lack of female hormone can be associated with osteoporosis which tends to weaken bones and predispose to fractures, although, to my knowledge, it is unclear as to whether it affects fracture healing.

    Hypothyroidism has been shown to affect certain aspects of bone healing.

    Excessive weight might be a factor in bone healing to the extent that it might affect immobilization if and when you are bearing weight.

    Smoking is certainly very bad for circulation in the extremities and that would likely have a negative influence on bone healing.

    Anything to do with the specifics of treatment, such as what sort of shoe you might wear should be asked of and answered by the attending doctor.
     
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