Fifth metatarsal osteotomy - healing challenges

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.
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The general information answer is that a well fixed osteotomy of a metatarsal will generally clinically heal in the healthy patient with good circulation and no complicating factors in about 6 weeks. I have no idea whether your osteotomy will heal in that time or not . . . or if at all. I do find it curious that your doctor seems to be determining healing by having you try it out, if in fact that is an accurate description of what you were told.

 

I also find it curious. Since I have no experience with this, and have seen only this doctor, I don't know what IS customary for assessing healing at this point. It caught me as unsettling, as I said, but I had no basis from which to know whether this was normal. I am a cautious (sometimes overly so) patient, and am now considering whether I should see someone else.

 

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.
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I am not going to interject myself into your doctor-patient relationship, but I would suggest that someone in your position might address the concerns such as have been expressed here with his/her doctor, and if one still doesn't receive an answer with which he/she is comfortable, then one would generally do well to ask him/her doctor for a second opinion referral or chose one him/herself. This is not a matter of sparing a doctor's feelings. The patient is the employer and deserves answers he/she can understand and trust.

 

What is missing here apparently an "informed patient"

Was a surgical consultation given to you preoperatively?
Were you told what was going to be done, how long you could expect to be in a post op cast/shoe/cam walker, etc... possible complications, alternative treatments?

You're anxious because you are worried that something is wrong and your surgeon is not giving you the information you need.

Next time you visit, don't leave his office until he answers your concerns. Your surgeon should be completely embarrassed that one of his patients is so confused and worried during her post operative period that she feels compelled to seek answers on a internet forum.

Steve

S. Arbes, DPM, FACFAS

 

Thanks for your reply, Steve. I didn't understand your first sentence though: "What is missing here apparently an 'informed patient.'" Will you please clarify?

I did visit with my doctor a week and a half before surgery, during which time we did discuss the procedure. I was told I'd be in a cast 3 weeks, then he would gauge next steps based on x-rays (of course, at 4 weeks when x-rays were read, he was unable to tell me if he thought my bones were healed. I have no idea if this is ordinary or not.)

I was told only about possible complications of the surgical procedure (blood clots, etc). I did not anticipate the troubles I am having now, so was not poised with these associated concerns pre-operatively.

Currently I am struggling with my foot turning dark purple when I put my foot down for any period of time. It is also very cold all the time, and I may call my doc to discuss these concerns tomorrow.

 

I had a similar procedure completed on 5/19/11 and was wondering how yours ended up recovering.

I am currently only 3 weeks into my healing process, but I am thankfully not experiencing any problems.

What I am asking is:
1. How long did your foot take to heal enough to walk/run?
2. Did you need any physical therapy after it healed?

 

I had 1-4 (Osteotomy) on August 25th and am experiencing pain and numbness in some of the areas.

I too had much swelling and am in the boot still today.

I would like to know what other experienced as far as walking/running time after their surgery.

Everyone is obviously different but just want to know in general.

Thanks!

 

I had a bunyonectomy and Osteotomy on my first metatarsal 7 weeks ago. I am now walking on the side of my foot without the boot and completely with the boot. But I'd like to comment about pain and swelling. My doctor advised me to keep it elevated with an ice pack on the side of my ankle for the first 4 days. The ONLY time I had pain is when we ordered dinner out, which is saltier than I normally eat. The swelling from the salt caused much pain afterwards. I told my doctor this and he said that is exactly what happens. So as long as I keep with my healthier low salt diet, I have no pain. He said this type of surgery shouldn't be very painful if one maintains a healthy regemine.

I imagine that due to immobility, most people tend to order out or eat processed foods. I even had pain after eating frozen lowfat dinners that were high in salt. At my age I'm discovering that the healthier I eat, the better I feel and the quicker I heal. And when I fall off the wagon--I can really feel the consequences!

 

I've read that healing takes a long time to show up on an x-ray, this is why they generally only do a second x-ray after 6 weeks as that is how long it takes the bone to become apparent enough to show up. Pain is usually a sign that something is wrong so i would keep off your foot for now, and just use your walking boot until your next appointment. I wouldn't walk bare foot at all.

 

I would suggest getting a knee roller/knee walker, you can rent them from a surgical supply store. This way you don't step on your foot until you are more comfortable.

 

I am currently 3 weeks out of surgery. I walked out of the hospital in a boot after my operation. Stopped taking painkillers 2 days after and went to work 3 days later. Around 5 days in I was sick of the boot started walking without it and was kicking a soccer ball fine. I have no pain and have surgery scheduled for my second foot as well now. Plan to have the screws removed as soon as they let me. Which I feel should be around 6 to 8 weeks for me.