Recovery Concerns for Fifth Metatarsal Fracture: A Patient's Journey

Issues Related to Recovery from Fifth Metatarsal Fracture

Hello Doctor: On December 23, 2017, I sustained a non-displaced closed fracture of the fifth metatarsal in my left foot due to a misstep.
I applied ice for nearly 48 hours and on December 25, I had a fiberglass cast applied at the Chung Cheng Orthopedic Clinic in Kaohsiung.
After reviewing the X-rays, the doctor estimated a recovery period of about one month.
Since I work in Japan, I had to return there for rest and rehabilitation.
On January 5, 2018, I visited an orthopedic hospital in Japan, where I had the U-shaped cast changed three times on January 5, January 12, and January 19, along with three X-ray examinations.
By January 19, the doctor indicated that I was healing well, with the fracture lines on the dorsal side of the metatarsal gradually becoming less visible, but there was an estimated 0.8 cm long fracture line on the plantar side.
The doctor applied slight pressure around the fracture site and asked if it hurt; I felt a bit of pain, but it was not severe enough to cause me to withdraw my foot.
Since my company expects me to return to work on January 26, the doctor has not yet mentioned when I can remove the cast.
If there is still such a fracture line and I walk without the cast, could it lead to a secondary injury? After January 17, while still in the cast, I tried to walk with weight on my feet without feeling pain.
Is it safe to continue practicing walking in the cast? Could this cause the fracture to worsen? Currently, it is very cold in Japan, and the bruising on my toes is slow to resolve.
I have been using a hot water bottle on my foot for 10-15 minutes over the past two days, which has helped a bit.
Would it be effective to apply heat to the entire dorsal surface of my foot? Could this help improve blood circulation? I apologize for my many questions, as I am anxious about not being able to return to Taiwan for a consultation.
Thank you.

Ying, 20~29 year old female. Ask Date: 2018/01/19

Dr. Shi Guozheng reply Orthopedics

1.
Walking with a cast will not cause secondary injury.

2.
The fracture will not worsen as long as the cast is not removed too early.

3.
Heat therapy can aid in blood circulation.

4.
Typically, healing occurs in about six weeks.

Reply Date: 2018/01/19

More Info

Recovering from a fifth metatarsal fracture can be a challenging journey, especially when you are managing it in a foreign country. Based on your description, it seems you have taken the right initial steps by applying ice and seeking medical attention promptly. The fact that you have been monitored through X-rays and have had your cast changed multiple times indicates that your medical team is attentive to your healing process.

To address your concerns:
1. Risk of Secondary Injury: If your doctor has indicated that the fracture is healing well, it is generally safe to begin weight-bearing activities, but this should be done cautiously. Walking with a cast can provide some stability and support, but it is crucial to listen to your body. If you experience pain while attempting to bear weight, it may be a sign that you are putting too much stress on the healing bone. Continuing to walk without pain while in the cast is a positive sign, but you should avoid pushing yourself too hard.

2. Walking Practice: Practicing walking while in a cast can be beneficial, as long as you are not experiencing significant pain. The cast is designed to immobilize the fracture site, allowing it to heal while providing some protection. However, be cautious about overexerting yourself, as this could potentially lead to complications or delayed healing. If you feel comfortable, you can practice walking with the cast, but always prioritize your comfort and pain levels.

3. Heat Application: Using a hot water bottle to promote blood circulation can be helpful, especially in cold weather. Applying heat to the foot can help alleviate stiffness and improve blood flow, which may assist in the healing process. However, be careful not to apply heat directly to the cast, as it may not be effective and could potentially damage the material. Instead, focus on warming the areas of the foot that are accessible and not covered by the cast.

4. Monitoring Progress: Since you are in Japan and unable to return to Taiwan for follow-up care, it is essential to maintain communication with your healthcare providers. If you have any concerns about your healing process, such as persistent pain or swelling, consider seeking a local orthopedic specialist who can evaluate your condition and provide guidance tailored to your situation.

5. Returning to Work: If your company expects you to return to work soon, ensure that you are physically ready to do so. Discuss with your doctor the implications of returning to work, especially if your job requires standing or walking for extended periods. It may be beneficial to have a conversation with your employer about potential accommodations during your recovery.

In summary, while it is encouraging that your fracture appears to be healing, it is essential to proceed with caution. Listen to your body, avoid pushing through pain, and maintain open communication with your healthcare providers. If you have any doubts or experience new symptoms, seek medical advice promptly. Your recovery is a priority, and ensuring that you are on the right track will help you return to your normal activities safely.

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