Recovery from Fifth Metatarsal Fractures: Common Concerns

Follow-up for fifth metatarsal fracture?

Hello Dr.
Lee, thank you for your previous response, which has reassured me a lot.
Currently, although the affected area is still somewhat swollen, I can walk using the inner edge of my foot, but I occasionally experience a tingling sensation in my sole and some discomfort.
Today, during my follow-up appointment, I had another X-ray taken, which can be viewed here: 3/28: https://imgur.com/a/LLDGF and the previous one from 3/5: https://imgur.com/a/jZdlp.
Many doctors have assessed that a fracture may still show signs of a crack after one month, and it typically takes about three months to heal.
I would like to ask if my current condition is normal.
I read that supplementing with iron and calcium can speed up recovery, but does it also depend on individual constitution? Have there been cases of healing within two months? Due to work, I need to move around; is moderate movement beneficial for healing? I have seen conflicting articles on this matter, with some suggesting movement and others advising against it, so I am unsure what to do.
A Japanese doctor mentioned that the bone healing process might result in the bone becoming thicker than before, and then it would self-correct to return to its original state.
Is this typical for bone fractures? I apologize for the many questions, and thank you once again for your care and responses, Dr.
Lee.

A-Jia, 30~39 year old female. Ask Date: 2018/03/28

Dr. Li Yongheng reply Orthopedics

Hello, generally speaking, it is normal for a fracture to still show signs of a crack on an X-ray after one month, and it typically takes at least three months for it to heal completely.
Therefore, your current condition appears to be normal.
Adequate calcium and vitamin D can aid in fracture healing, but it is uncommon for a fracture to fully heal in just two months.
Moderate walking can be beneficial for healing, but it is also advised not to walk too much to avoid swelling in the foot.
Bone healing may result in the bone becoming slightly thicker due to callus formation, which is also a normal phenomenon, but it should not become significantly thicker, so there is no need to worry.
Wishing you a speedy recovery.

Reply Date: 2018/03/28

More Info

Recovery from a fifth metatarsal fracture can be a complex process, and it's understandable to have concerns about your healing progress. Based on your description, it seems you are experiencing some common symptoms associated with this type of injury, including swelling, occasional sharp sensations in the foot, and fatigue in the foot muscles. Let's address your questions and provide some insights into the recovery process.

1. Healing Timeline: It's typical for a fifth metatarsal fracture to take several weeks to months to heal. While some fractures may show significant improvement in about four to six weeks, complete healing often takes around 8 to 12 weeks, depending on the severity of the fracture and individual factors such as age, overall health, and activity level. The presence of a visible crack on X-rays after one month is not unusual, as bone healing is a gradual process.

2. Nutritional Support: Adequate nutrition plays a crucial role in bone healing. Calcium and vitamin D are essential for bone health, and iron can support overall recovery. However, individual responses to supplementation can vary. It's wise to consult with a healthcare provider or a nutritionist to tailor a plan that suits your specific needs and to ensure that you are not exceeding recommended dosages.

3. Activity Level: The question of whether to remain active or to rest can be confusing. Generally, moderate activity can promote circulation and may aid in healing, but it’s essential to avoid putting excessive weight on the injured foot until your doctor advises otherwise. Walking on the inner edge of your foot is a good strategy to minimize pressure on the fracture site, but be cautious of any pain that may indicate you are overdoing it. Listening to your body is key; if you experience increased pain or discomfort, it’s best to reduce activity and consult your physician.

4. Bone Healing Characteristics: The notion that a fractured bone may heal thicker and then remodel to its original shape is accurate. This process, known as bone remodeling, allows the body to adapt to stress and can lead to a stronger bone structure post-injury. However, this remodeling can take time, and the final outcome may not be evident for several months after the fracture has healed.

5. Follow-Up Care: Regular follow-up appointments with your healthcare provider are crucial to monitor the healing process. If you have concerns about the sensations you are experiencing, such as the "electric shock" feeling, or if the swelling persists, it’s important to discuss these symptoms with your doctor. They may recommend imaging studies or physical therapy to address any underlying issues.

6. Physical Therapy: Once your doctor gives the green light, engaging in physical therapy can be beneficial. A physical therapist can provide exercises tailored to your recovery, focusing on strength, flexibility, and balance, which can help restore function and prevent future injuries.

In summary, while your current symptoms may be concerning, they are not uncommon in the recovery from a fifth metatarsal fracture. Healing takes time, and it’s essential to balance activity with rest. Keep an open line of communication with your healthcare provider, and don’t hesitate to reach out with any new or worsening symptoms. Your proactive approach to understanding your recovery will serve you well as you navigate this healing journey.

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