Managing Fifth Metatarsal Fractures: Recovery Tips and Future Considerations

Fifth metatarsal bone

Hello! Four to five weeks ago, I twisted my ankle while running, resulting in a transverse fracture at the base of the fifth metatarsal in my left foot.
The doctor advised me to wear a brace without crutches and to walk to work as usual.
After four weeks, an X-ray showed that the fracture had displaced, and there was a hard lump protruding at the injury site.
The doctor assessed that the degree of displacement was acceptable, so he recommended against surgery and advised me to continue wearing the brace.
I have a follow-up appointment in four weeks.

What should I do or avoid doing before my follow-up appointment to prevent further displacement? What are the potential long-term consequences of the current displacement? I have a habit of exercising, such as long-distance running; will I be able to continue running in the future, or should I switch to other forms of exercise? Will my metatarsal be more prone to degeneration due to the displacement? How can I reduce the risk of degeneration? Does the hard lump need to be corrected? Thank you!

Dì wǔ zhǐ gǔ, 40~49 year old female. Ask Date: 2018/03/03

Dr. Shi Guozheng reply Orthopedics

Currently, intense exercise is not advisable.
After healing, it will still be possible to engage in activities like running, and this joint is less likely to develop degenerative joint disease changes, so no correction is needed.

Reply Date: 2018/03/03

More Info

Managing a fifth metatarsal fracture can be a challenging process, especially when complications such as displacement occur. Your situation, where you sustained a transverse fracture of the fifth metatarsal base while running, is not uncommon. The fifth metatarsal is particularly susceptible to fractures due to its location and the forces exerted during activities like running. Here’s a comprehensive overview of recovery tips, future considerations, and answers to your specific questions.

Immediate Management and Recovery Tips
1. Follow Medical Advice: Since your doctor has advised you to continue wearing a protective boot and has deemed the displacement acceptable, it’s crucial to adhere to this guidance. The boot will help stabilize the fracture and prevent further movement that could exacerbate the injury.

2. Limit Weight Bearing: Although you are allowed to walk, try to minimize the amount of weight you place on the injured foot. Use crutches if necessary to avoid putting pressure on the fracture site, especially during the initial healing phase.

3. Ice and Elevation: To manage swelling and discomfort, apply ice to the affected area for 15-20 minutes several times a day. Elevating your foot can also help reduce swelling.

4. Monitor Symptoms: Keep an eye on any changes in your symptoms. If you notice increased pain, swelling, or any changes in the shape of your foot, contact your physician immediately.

5. Gradual Return to Activity: Once you receive clearance from your doctor, gradually reintroduce activities. Start with low-impact exercises that do not place excessive strain on your foot, such as swimming or cycling, before returning to running.

Future Considerations
1. Potential Long-Term Effects: Displacement of the fracture can lead to complications such as malunion or nonunion, where the bone does not heal properly. This can result in chronic pain or instability in the foot. Regular follow-ups with your physician and imaging studies will help monitor the healing process.

2. Running and Other Activities: Once healed, many individuals can return to running. However, it’s essential to listen to your body. If you experience pain during or after running, it may be wise to switch to lower-impact activities or consult a sports medicine specialist.

3. Risk of Degeneration: There is a possibility that the displaced fracture could lead to an increased risk of arthritis or degeneration in the joint over time. To mitigate this risk, focus on maintaining a healthy weight, engaging in regular low-impact exercise, and strengthening the muscles around the foot and ankle.

4. Addressing the Hard Lump: The hard lump you mentioned could be a callus or a bone spur forming as part of the healing process. It’s essential to have this evaluated during your next appointment. If it causes discomfort or affects your mobility, your doctor may recommend further treatment.

5. Preventing Future Injuries: To reduce the risk of future fractures, consider incorporating strength training and flexibility exercises into your routine. Proper footwear that provides adequate support and cushioning is also crucial, especially for high-impact activities like running.

Conclusion
In summary, managing a fifth metatarsal fracture requires careful attention to your recovery process and adherence to medical advice. While the current displacement is deemed acceptable, ongoing monitoring is essential to ensure proper healing. With appropriate care, many individuals can return to their previous activity levels, including running. However, it’s vital to approach your recovery gradually and be mindful of any changes in your symptoms. Always consult your healthcare provider for personalized advice tailored to your specific situation.

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