Recovery from Metatarsal Fractures: Expert Advice

Questions regarding fractures of the second, third, and fourth metatarsals?

Hello Dr.
Chen, I have had fractures in my second, third, and fourth metatarsals for nine weeks now.
My cast has been removed, and I have been undergoing rehabilitation for three weeks.
I have some questions regarding the medical practices here abroad, so I would like to ask for your advice.
Thank you!
1) At my eight-week follow-up appointment, the doctor said I no longer needed to use crutches and did not need to return for further check-ups.
After trying to walk without crutches, I experienced some mild pain.
Is this normal? Should I continue using crutches or stop using them altogether?
2) Does walking more help speed up the healing process?
3) How long will it take before I can walk normally without crutches? From what I have read in previous Q&A sessions, it seems to be around three months?
4) How long will it take before I can stand up, squat down, and carry a child while walking?
5) I am unsure whether in Taiwan, patients with fractures need to receive anticoagulant injections.
If so, do these injections need to continue until I can walk without crutches?
Thank you for your response, Dr.
Chen!

Miss Shi, 30~39 year old female. Ask Date: 2020/08/30

Dr. Chen Bochen reply Orthopedics

Hello Ms.
Shih, due to the absence of your X-ray and personal physical examination, I will respond to your medical inquiries as follows:
1) During your eight-week follow-up, the doctor mentioned that you no longer need to use crutches and do not need to return for further appointments.
After trying to walk without crutches, you experienced some mild pain.
Is this normal? Should I continue using crutches or stop using them?
- Generally, after eight weeks of a metatarsal injury, you should be able to walk normally.
If you experience pain, it is acceptable to use crutches for support, but the principle is to avoid using them if possible.
The more weight the bone bears, the faster it can heal.
2) Does walking more help accelerate healing?
- Yes, increased weight-bearing activity can promote healing.
3) How long will it take until I can walk normally without crutches? I have seen that most responses indicate around three months?
- Typically, it takes about six to eight weeks to walk normally after such an injury.
4) How long will it take until I can stand up, squat, and carry a child while walking?
- Generally, this can be achieved within six to eight weeks.
5) In Taiwan, is it necessary to administer anticoagulants for fractures? If so, should the injections continue until I can walk without crutches?
- The incidence of thrombosis is lower in Asian women, and typically, anticoagulant therapy can be discontinued after about one month, but adjustments should be made based on clinical symptoms.

Reply Date: 2020/08/30

More Info

Hello! Thank you for your questions regarding your recovery from metatarsal fractures. It's great to hear that you've already had your cast removed and have been undergoing rehabilitation for three weeks. Let's address your concerns one by one.

1) Mild Pain After Walking Without Crutches: It is not uncommon to experience some mild pain after transitioning from crutches to walking unaided, especially after a metatarsal fracture. The bones and surrounding soft tissues are still healing, and your body is adjusting to the increased load on the foot. If the pain is mild and manageable, it may be a normal part of the healing process. However, if the pain worsens or becomes sharp, it would be wise to revert to using crutches temporarily and consult your healthcare provider for further evaluation.

2) Does Walking More Accelerate Healing?: While gentle walking can promote circulation and help with the healing process, it is essential to balance activity with rest. Overloading the healing bone too soon can lead to complications or delayed healing. Gradually increasing your walking distance while listening to your body is key. If you experience pain, it may be a sign to reduce your activity level.

3) Timeline for Walking Without Crutches: The timeline for returning to normal walking without crutches can vary significantly based on the severity of the fractures and individual healing rates. Generally, many patients can walk without crutches within 6 to 12 weeks post-injury, but this can vary. Your doctor’s advice to stop using crutches at eight weeks is common, but it’s essential to listen to your body and not rush the process.

4) Getting Up, Squatting, and Carrying Children: The ability to perform activities like squatting and carrying a child will depend on your pain levels, strength, and stability in the foot. Typically, patients can start performing these activities around 3 to 6 months post-fracture, but this can vary. It’s crucial to ensure that you have regained adequate strength and balance before attempting these movements to prevent re-injury.

5) Anticoagulation Therapy in Taiwan: The use of anticoagulants after a fracture is generally based on individual risk factors for thromboembolism, such as prolonged immobility or other medical conditions. In many cases, patients may not require anticoagulation therapy unless they have additional risk factors. If anticoagulants are prescribed, they are typically continued until the patient is fully weight-bearing and mobile, but this decision should be made by your healthcare provider based on your specific situation.

In summary, recovery from metatarsal fractures can take time, and it’s essential to follow your healthcare provider's advice while also listening to your body. Gradual increases in activity, managing pain levels, and ensuring you have adequate strength and stability are crucial for a successful recovery. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further guidance. Wishing you a smooth and speedy recovery!

Similar Q&A

Rehabilitation Tips for First Metatarsal Fracture Recovery After Surgery

Hello, I would like to ask about my condition. I sustained a fracture of the first metatarsal with a closed fracture and joint collapse after a car accident on November 2nd. I had surgery on December 5th, and the doctor has now removed the cast. I would like to know about rehabil...

Dr. Hong Ximing reply Orthopedics
Foot fractures can lead to joint stiffness post-surgery. It is advisable to consult a rehabilitation specialist for appropriate rehabilitation methods. However, the rehabilitation process can be challenging and requires perseverance.

Effective Rehabilitation Strategies for Fractured Metatarsals After an Accident

Since your accident at the end of this month, you have been experiencing soreness, tightness, and pain daily in your fractured second and fourth metatarsals. What rehabilitation should you pursue?

Dr. Zhou Jianwen reply Rehabilitation
First, confirm that the fracture site is properly stabilized before beginning rehabilitation.

Rehabilitation Tips for Recovery After a Fifth Metatarsal Fracture

Description: A fall down the stairs resulted in an oblique fracture of the fifth metatarsal in the left foot, which also exhibited displacement. Following the doctor's recommendation, surgery was performed, and absorbable bone screws were inserted. It has now been five weeks...

Dr. You Dianqi reply Orthopedics
Each person's recovery situation is different. It is recommended to consult your primary physician or seek an evaluation from a rehabilitation specialist. Thank you.

Understanding First Metatarsal Fractures: Diagnosis, Treatment, and Recovery Tips

Hello, doctor. I would like to ask some questions. Last week, I was involved in a car accident where I was rear-ended. During the emergency visit, I was informed that I have a fracture of the first metatarsal (the X-ray is as follows: https://upload.cc/i1/2022/12/22/eJyt9P.jpeg)....

Dr. Shen Boquan reply Orthopedics
Hello, I apologize, but I cannot view your X-ray. Even if I could, the resolution and image quality would not be as clear as those taken in a hospital. The bones in the foot are quite numerous and complex. Sometimes, additional imaging such as a CT scan may be necessary for confi...