5th Metatarsal fracture...

Hello all,

About 3 weeks ago my right foot rolled off a step and ended up wedging it between the ground and the step while falling to the side...The x-ray at the walk-in clinic showed a 5th metatarsal oblique fracture, slight displacement. The doctor gave me an air-cast to walk in for 4 weeks. At the end of the 4 weeks I'm to have a follow up x-ray to diagnose the healing process.

By the end of the 1st week I would say that at least half of the pain was gone. Since then however, the pain has only marginally gotten better.

Last week I noticed that the base and interior "webbing" of my 3rd, 4th and 5th toes had some purple bruising and was painful to the touch. These toes have been going into spasms at least 8-10 times a day, with varying pain from mild to intense.

Now 3 weeks in, I've noticed that my 5th toe does not want to separate from the 4th toe while stretching. And if I try to move the 5th toe away from the 4th with a finger there is some moderate pain and it feels like it wants to go into a spasm.

As far as the fracture itself it feels like a small slightly hardened bump has grown at the fracture site. Which I think is a good sign however I still have some pain if I touch the affected area. I still have a deep green bruise under my foot, directly underneath the 5th metatarsal.

I guess my question is if this is a normal occurrence regarding the toe spasms? Is it possible that the bone is healing but perhaps not healing correctly, hence the 4th and 5th toes touching without separation?

Thank you for reading this far down on my long-winded post! :)


Joe

Hi Joe,

Sorry to hear about your injury, sounds very unlucky.

I think this is a bit out of my scope of practice but I would try not to worry about it until you are out of the aircast. I have seen a few athletes with this injury and never had a problem. It might be to do with the stiffness and 'lack of action' of the extensor tendons while they have been in the boot and when you get moving again it will resolve along with a bit of manual treatment if necessary. That would be my first treatment option. If you have functional problems and it really affects your gait I would get an orthopaedic opinion and see if there is issues with the fracture sight.

Of the players I have seen a couple had spasms but not in the way you describe. So it can be a normal response. It is definitely healing as you have identified with the lump but as to whether it is healing 'properly; I would give it another week until you are out of the aircast.

Hope this helps, let us know how you get on after to boot.

Ben

Hi Ben,

Thank you for responding to my questions. Very much appreciated!

So, I just got back home from the doctor and had my follow up x-ray. The results were that the bone almost completely re-aligned itself. There was a very small corner that was "off".

Now, the slightly bad news is that according to the doctor, only a small amount of soft callous has grown over. I asked him how far long percentage-wise the bone was and he said his best guess was 30-40% healed so far. I was a little disappointed to hear that number, but I'm pleased that at least the bone has set itself correctly.

The doctor also confirmed what you had said in your post, that the spasms are most probably from the fact that the foot has been stuffed into a tight boot for 4 weeks. He saw no stress fractures in the toes or joint areas in the follow up x-ray.

The doctor wants me back in 5 weeks for another follow-up x-ray. During that time I'm to stay in the boot for another 3 weeks. For weeks 4 and 5, I'm to take the boot off and walk around the house wearing a stiff shoe. If I go out for any reason I'm to put the boot on.

After the 5 weeks, if the results keep up or get better and that I'm around 75-80% healed he will refer me to a physiotherapist and we'll see where we go from there.

All in all not happy but not upset about the results...wish me luck! :)

Take care,

Joe

Hi

i have a 5th metatarsal fracture too. 8 weeks ago now. I was in an air boot for 5 weeks and I never put any weight on foot at all out of the boot. Did everything I should. Had X-ray at 5 weeks absolutely no healing. I was quite surprised and disappointed to say the least. Surgeon said to try and put some weight on foot, pain is my guide, if it hurts stop and wear boot or elevate. Funny enough It did not hurt to walk on it, I did have some pain in my toes but not at the site where it was broken. So I wore the boot off and on at home, then a sturdy shoe when not in boot and always wore air boot when I went out. The toe pain got better and I am pretty well pain free in the toes now. The rest of foot is good too except id I have overdone it walking like today Christmas Day. I went Monday last now 8 weeks since I fractured foot and again no healing has taken place. I am very frustrated. If you squeeze the spot where it is broke it hurts, to walk on it, it is good. So why isn't it healing. I hear people have pain and are healing. I am supposed to be getting a bone stimulator now if my health plan will cover it. Don't know if this will work. Hope so. I think your toe problems will get better the more you walk on it mine did. Any suggestions for me.

so frustrated not being able to drive, would appreciate any info from anyone.

thanks
Janet

Consult a doctor and try physical therapy. It would be effective to heal your toe.