Slow Healing of the Fifth Metatarsal Fracture: Key Recovery Tips

Delayed union of the fifth metatarsal bone?

Hello! Over eight weeks ago, I accidentally twisted my ankle, resulting in a transverse fracture at the base of the fifth metatarsal in my left foot.
I went for a follow-up today, and the X-ray showed that the crack is still present; the doctor said it is only 50% healed and that I should continue wearing a walking boot.
I have been resting at home for six weeks and just returned to work two weeks ago.
Now, aside from work, I am resting at home.
I take a taxi when going out to avoid excessive walking.
I have a few questions:
1) Given that I am only 50% healed, should I continue to immobilize the foot?
2) If I wear the boot for protection, can I walk a bit more (like taking the subway or going to the market)?
3) Should I pay attention to my walking posture (like using a heel-to-toe gait) while walking before it is fully healed?
4) Due to work commitments, it is not feasible to wear the boot at work long-term.
Should I wait until it is completely healed before I can stop using the boot? How much longer until I can fully heal and walk normally?
5) Can I take supplements to accelerate healing (my vitamin D levels have always been low)?
6) My left calf has atrophied; will it recover? Thank you!

Pink, 40~49 year old female. Ask Date: 2018/03/22

Dr. Shi Guozheng reply Orthopedics

1.
Physical activity should be restricted.

2.
Walking more does not aid in bone healing; walking less is more beneficial.

3.
There is no need to walk on your heels.

4.
Healing will take approximately three months.

5.
There are no additional comments.

6.
Exercises can be performed to regain muscle strength.

Reply Date: 2018/03/22

More Info

Hello! It sounds like you've been through quite a challenging recovery process with your fifth metatarsal fracture. Here are some insights and recommendations based on your situation:
1. Continued Immobilization: Given that your fracture is only 50% healed after eight weeks, it is crucial to continue immobilization. The healing process for a fifth metatarsal fracture can vary significantly among individuals, but it typically takes around 6 to 8 weeks for initial healing, and sometimes longer for complete recovery. Continuing to wear your protective boot is essential to prevent further injury and to allow the bone to heal properly.

2. Mobility with Protection: While wearing a protective boot, you may be able to increase your mobility slightly, but it is important to listen to your body. If you feel any pain while walking, it’s best to limit your activities. Using public transport like the subway or going to the market should be approached cautiously. If you do decide to walk, ensure that you are not putting excessive weight on the injured foot.

3. Walking Posture: Yes, maintaining a proper walking posture is crucial, especially when your fracture has not fully healed. Walking on your heel (heel-to-toe gait) can help distribute weight more evenly and reduce stress on the fracture site. Avoid putting too much pressure on the forefoot, as this can exacerbate the injury.

4. Returning to Work: If your job requires you to be on your feet or to walk extensively, it may be wise to discuss options with your employer, such as working from home or modifying your duties until you are fully healed. It is generally advisable to continue using the boot until you have complete healing, which can take anywhere from 8 to 12 weeks or longer, depending on various factors including your age, overall health, and adherence to rehabilitation protocols.

5. Nutritional Supplements: Yes, nutritional support can play a significant role in bone healing. Since you mentioned having low vitamin D levels, it would be beneficial to discuss with your healthcare provider about taking vitamin D supplements, as this vitamin is crucial for calcium absorption and bone health. Additionally, consider ensuring adequate intake of calcium and protein, as both are essential for bone repair.

6. Muscle Atrophy: It is common to experience muscle atrophy in the calf due to disuse during recovery. The good news is that muscle can regain strength and size with appropriate rehabilitation exercises once your doctor gives you the green light to start moving your foot more. Physical therapy can be very beneficial in this regard, focusing on strengthening exercises for the calf and foot.

In summary, continue to prioritize rest and immobilization for your foot, monitor your pain levels, and maintain a proper walking posture. Consult with your healthcare provider about dietary supplements and rehabilitation exercises as you progress in your recovery. It’s essential to be patient and allow your body the time it needs to heal properly. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. Wishing you a smooth and speedy recovery!

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