5th metatarsal displaced fracture

Foot care
1

Hello

10 days ago I fell down the stairs and i fractured my 5th metatarsal.  It is displaced and fractured in two places - please see image. 

Emergency put me in a moon boot and a week later I went to the fracture clinic.  The registrar and the surgeon who ran the clinic said that it should heal on his own, new bone will grow over even though it is displaced.  These fractures are forgiving but do take time.  They got a third opinon from antoher orthopaedic surgeon who specialises in feet bones and he asked for me to come back the next week. 

i went in today and he has given me the option of surgery.  he has not given me a preferred options or a preference and has said it is up to me.  i feel quite confused and am not sure what to do.  he said i can leave it to heal the way it is, and it may be absolutley fine, or it might give me problems and shortening in the long run.  i am a fairly active person, a minium of 6 times a week walking/running/weight training/resistance training/intervals cardio etc. their is a chance that my foot will not heal to that level again, or it might heal fine, we just dont know.  if i do surgery, they will screw and plate the bone back into place so it will be in the best position to heal correctly, boot time is the same amount as non surgery, 6 weeks, but obviously the recovery is a bit longer with getting strength etc back. 

I am a bit scared with the risks assocaited with surgery, the 10% chances of things going wrong, infection, etc.

I am unsure what to do.  I dont want do let it heal the way it is, just to give me problems as it is, but what if it heals fine? or what if surgery makes it worse. 

i am a 29 year old female, non smoking.  very fit and active.

the doctor had compared my original x-rays with x-rays taken 10 days later and the bone had moved over (towards my 4th metatarsal) so not for the better.

i heard the surgeon say it would have been easier to operate on the way it broke initially but it makes it a bit tricky now its moved over, which makes me nervous. 

any info or opinions would be helpful.

Thank you

2

Mine too moved, and each time it did the gap got larger, to such an extent the surgeon advised it would never heal on it's own, so I had the op. Am I glad I had it then, not quite three weeks after the fracture, I kept seeing a woman in fracture clinic who had a similar fracture, both of us had fractures in the area notorious for taking a long time to heal (though I fractured my ankle as well). She chose to wait and see if it would heal on it's own, on the day I was being discharged she was back in just having the stitches out after her op.

3

Hi Susan, 

Thank you for your reply, how bad was your fracture intiially, comapred to mine (xray is attached?) Was it similar? I am now anxious waiting for a surgery date, i would have been in boot for two weeks this coming Saturday, and they said they wouldnt leave it long, but if its not until another 3 weeks, i would be inclined to leave it than start the whole process of heaing and 6 week boot all over again, but now reading your experience, it seems surgery might be worth it in the long run. 

Was it your 5th? How soon after surgery and removal of boot did it take for you to really feel yourself again in your foot?

Thank you

4

Mine was the 5th metatarsal, though the break was at the other end from yours, hence the problem of healing (due to the poor supply of blood vessels) surgeon took one look and told me I was going to get arthritis in both as the fractures go through the joints. I ended up with just a screw put through it, but because I'd broken my ankle as well I had to be put in plaster for six weeks, I then had the boot for eight weeks. Once I was in the boot I was able to start rotating the ankle etc (normally whilst in the bath) so that by the time I started physio I'd almost got full rotation back. I did mine back in February, it's still a little painful when I walk or stand on it for too long and I still can't walk on sand or in say a field or wear shoes with a heel. But this is because of 1 the ankle and 2 bone density loss (non weight bearing age and having had a total hysterectomy caused that so you won't have those problems).

You surgeon will get you in asap I only waited a week (7 days from when they decided I needed to see a surgeon 3 days after I'd seen him). I had the surgery early afternoon and went home that night, could have stayed in if I wanted to, once you're vital signs are OK it's just a matter of how are the pain is and mine was no worse.

If I was you I'd have it done, just make sure that once you've had the stitches out and the scar is healing you rub plenty of cream (moisturiser with no perfume) into it, you rub it in quite hard in little circular movements, this helps the wound not form heavy scar tissue and keeps it supple.

Let me know when you have your surgery date.

Good luck

Sue

5

I have just been told today that I am in for surgery tomorrow morning.  I am on the trauma list so if anyone more urgent comes in, i am bumped off but at least i am in the hospital with a bed and theyll keep me there until it is done. 

With regards to your heels, is it more your injury to your ankle or the metatarsal that causes it to be difficult to wear heels?  I am getting married in 15 months, and i also work in a field where heels are a daily shoe!

I agree with you, and i feel much more better about getting it done now its so soon.  If i had been made to wait much longer, i would have questioned whether i should just leave it.  It's two weeks this saturday the injury, and they agreed on surgery this Tuesday just gone.  Pretty ok for a public health system.  Fingers crossed.

The hospital, when i went to emergency, told me i could walk in the boot, but i really think that was bad information, since it is still sore adn the bone has moved since.

Thank you for your replies, its great to get some insight from someone else, you've made me feel better about my decision.  I wish you all the best in your recovery, it has been long, but it will get there. smile

6

It's my ankle causing problems wearing heels, so you shouldn't have that problem.

Physio and surgeon told me no bare feet, no heels, no flip flops etc for at least another year, my ankle needs support, yet of all things they recommend crocks, worn with the strap behind the heel and boy were they right. I now have three pairs, all different colours.

I too was on the emergency trauma list, with a note saying it couldn't be postponed, I was down for first thing but ended up with two before me (both children). They'll want to do it now whilst the fractured ends are still quite new, if they start to heal over the surgeon then has to clean up the ends and often put in a bone graft. You're well in the time limit, good luck for tomorrow!!