5th metatarsal injury (apparently a bad one)

[dale483]

Hello all,

I have a quick concern about a injury which has occurred to me in the last few days.(injury is now 5 days old)

I fractured my 5th metatarsal, and went to the walk in centre x2 days later as at first i thought i had just badly sprained my ankle. X rays showed the break (in pic) and i was sent to the fracture clinic at A&E. The doctor there gave me a choice of a tubi grip or plaster, stating that the break was not bad enough for surgery and that it should heal itself, giving me a return app. for 4 weeks time, for another xray to be taken. My job and social life entail a lot of fitness and the doc said i would be able to do light bike work and rowing work, but no weight bearing on it while it was healing. This was in total contrast to the walk in centre who said i would need a op to pin it due to the fracture. I'm confused? And would like a answer regarding the fitness side as i'm dying to get back in the gym. I've also purchased a aircast sp walker instead of getting a cast on. Is this correct?

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[physiobob]

By the look of your X-ray you've suffered an oblique fracture of the distal shaft of the 5th metatarsal. This is actually quite common in dancers.

How did you do it? Were you up on your toes are the time? You definitely cannot and should not exercise or put any load on the foot (such as cycling) for at least 4-6 weeks until a repeat x-ray shows boney union.

In general fractures at that distal end of the metatarsal head do heal better with non-surgical intervention that those closed to the ankle end of the bone. This is as the proximal sites have poorer blood supply and often end in delayed bone union.

The conservative management requires a good reduction and position of the fracture. Has it been reduced (put back in place as good as it can). It there a repeat x-ray to show that? If so can you post it.

If it were my foot and I played a lot of sport I would ensure a good alignment if a non-surgical approach is the choice. Without that, and without time for good heading you can end up with a malaligned bone that can become problematic later on. In the end the choice is yours but if you want a second opinion (or 3rd) see a specialist foot surgeon.

[dale483]

Physio bob,

Thanks for your reply. No, it has not been realigned. It has been left as the xray shows and is in a tubigrip (awaiting the aircast walker to be delivered). It was done dancing, and i basically went over on what i thought was my ankle. From your reply i feel that it is probably best that i go to another hospital and get a second opinion from a foot specialist, as i need my foot to be right when it is repaired. Can i still train upper body muscles, and possibly use a hand bike regarding cardio vascular work?

Your reply is very much appreciated (can u have a quick gander at my other injury please!) Posted on same wall i think.

I am a emergency service provider and need to be back on my feet so your time taken to reply to me is appreciated greatly.

[physiobob]

Yep, definitely another opinion is in order. And NO to the bike right now. You can arm crank if they have one at your gym as that will get as good a heart rate response or sometimes better than cycling. Upper body training is fine.

[dale483]

Ok.

Attended a different hospital this morning. Doctor there took a new xray. Foot is now in plaster and an appointment has been made for a week on monday where a further xray will be taken. He has stated that it should heal by itself, but if the second xray shows no sign of cohesion, or that its still moving then he will pin it. Since it went into the plaster though its throbbing a bit!

Read up quite a bit on it and beginning to just wish they had pinned it, then it would have been done and dusted and i would be on way back to recovery. But i'll wait the 2 weeks and see what he says.... Fingers crossed..

I'll keep you informed.

[dale483]

Physio Bob,

Just a quick update after i sought your advice.

I obtained a 3rd opinion from a different hospital. They placed me into a cast for 2 weeks and i went back on Monday for a further xray. After questioning me about my lifestyle/job etc they stated exactly what you had said regarding correct alignment and yesterday i underwent a op to pin the fracture. I'm now home and have been told a 6 week recovery period is in order for the bone to heal, then probably another 6 weeks for me to get my calf muscles/ankle etc back in order.

The surgeon was a lovely man but he didnt see the funny side when i asked about doing upper body work at the gym, giving me a lecture on how femme the pin and bone would be until its unified. I understand this and will stay off it for the next few weeks but was wondering when i could seriously consider getting 'sweaty' again (upper body training). I dont want to do the cut or my stitches and harm at the moment.

Thanks again for the initial info and advice as you have probably saved me a load of future problems with my foot.