Recovery Timeline for Second and Third Toe Fractures After Surgery - Orthopedics

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How long after plate surgery for fractures of the second and third metatarsals can a patient begin to walk slowly?


Hello Doctor, I have fractures of the second and third metatarsals, a comminuted fracture of the medial cuneiform, and a partial dislocation with rupture of the plantar ligaments.
I opted for plate surgery and it has been two weeks since the operation.
During this time, I have been wearing a cast for immobilization.
Can I remove the cast and start walking slowly with crutches now? I have tried to apply weight on my heel while walking (with crutch assistance).
Will this affect my recovery? Additionally, when applying weight on my heel, should the sole of my foot be flat on the ground, or should my toes be elevated? Thank you!

wei, 20~29 year old female. Ask Date: 2020/07/21

Dr. Zhan Xian reply Orthopedics


Hello Ms.
Wei, generally, after a metatarsal fracture surgery, it is not recommended to bear weight on the affected limb for two weeks.
The timing for weight-bearing can vary for each case, so please consult with your surgeon, as they are most familiar with your surgical situation!

Reply Date: 2020/07/21

More Info


After undergoing surgery for fractures in the second and third toes, as well as a fracture of the medial cuneiform and a ruptured ligament, it's understandable to have questions about the recovery timeline and the appropriate steps to take post-surgery.
Firstly, it’s important to recognize that the healing process for toe fractures can vary significantly based on the severity of the fractures, the surgical technique used, and individual patient factors such as age, overall health, and adherence to rehabilitation protocols. Generally, after surgery for toe fractures, patients can expect a recovery timeline of about 6 to 8 weeks for the bones to heal sufficiently. However, full recovery, including regaining strength and mobility, may take longer.

Since you mentioned that it has been two weeks since your surgery, it is typically still early in the recovery process. Most surgeons recommend keeping the affected area immobilized for at least 4 to 6 weeks post-surgery to ensure proper healing. While you may feel ready to remove the cast and begin walking with crutches, it is crucial to follow your surgeon's specific recommendations regarding weight-bearing activities.
Walking with crutches and applying weight through your heel can be a part of your rehabilitation, but it should be done cautiously. When using crutches, you should aim to keep your toes elevated and avoid putting pressure on the fractured area. This means that while your heel can make contact with the ground, your toes should ideally not touch the floor to prevent any undue stress on the healing bones and ligaments.
If you are considering removing the cast, it is essential to consult with your orthopedic surgeon first. They will likely want to assess the healing progress through X-rays before allowing you to transition to a more active rehabilitation phase. Prematurely removing the cast or putting weight on the foot could lead to complications such as misalignment of the bones or delayed healing.

In terms of rehabilitation, once you receive clearance from your doctor, physical therapy can play a vital role in your recovery. A physical therapist can guide you through exercises designed to improve range of motion, strength, and balance. They will also provide you with strategies to safely transition from using crutches to walking independently.

To summarize, while it is encouraging that you are eager to start moving, it is crucial to prioritize the healing process. Consult your surgeon before making any changes to your current treatment plan, and follow their advice regarding weight-bearing activities. Once you receive the go-ahead, engage in a structured rehabilitation program to ensure a safe and effective recovery. Remember, patience is key, and taking the time to heal properly will lead to better long-term outcomes.

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