Fifth Metatarsal Fractures: Symptoms, Recovery, and Care

Q: Fifth Metatarsal Fractures: Symptoms, Recovery, and Care

1. <br>Do I need to elevate my leg while sleeping? Answer： If possible, the affected limb should be elevated to reduce swelling, not just during sleep. <br> <br>2. <br>When should electrical therapy for rehabilitation be initiated? Answer： Electrical therapy can be started once t

Fracture of the fifth metatarsal?

Hello, Doctor.
On November 7th, after hanging something, I slipped off a chair while stepping down, landing heavily on my right foot.
At that moment, my foot swelled, and I applied ice continuously for about ten days (not realizing I had a fracture).
By the third day, I noticed I could walk without pain, although my foot remained swollen with bruising, and I couldn't place my foot flat on the ground.
I thought it was just a simple sports injury and assumed resting would help once the swelling went down.
I tried to keep my weight on the heel and the inner side of my right foot.
After the injury, my activity was limited to home and the supermarket (which is normally a three to four-minute walk, but after the injury, it took about ten minutes).

Over half a month later, the bruising subsided, but I found I couldn't stand for long periods.
If I walked or stood for more than ten to twenty minutes, my right foot and the top of my foot would swell, and sometimes I couldn't place my foot flat on the ground.
I finally visited an orthopedic doctor on November 30th and had X-rays taken.
The doctor reviewed the images and noted that it was good I had applied ice, but I should have come in for an X-ray on the same day of the injury instead of walking around.
The doctor mentioned that I might need a cast, but since my activity was limited to home and the supermarket, I was advised to wear a walking boot (the blue type with Velcro) and to rest at home with my foot elevated, returning for another X-ray in three weeks.
I was concerned that the walking boot might shift, so I specifically bought a size small, which only allows my big toe to stick out a bit.
The area where my toe is fractured sometimes experiences sudden sharp pain, and I feel a tingling sensation when I place my foot on the ground.
At night, I take off the walking boot, but no matter how I position my foot, it doesn't feel comfortable.

I would like to ask:
1.
Is it necessary to keep my foot elevated while sleeping? (I haven't been doing this because it feels uncomfortable in any position.)
2.
When should I start electrical stimulation therapy for rehabilitation?
3.
If I walk slowly to the supermarket to buy things, will it slow down my recovery? (I'm worried that the fracture might worsen.)
4.
How much longer will it take for me to recover and walk normally? (Currently, my walking posture still has my weight on the heel and inner side of my foot.)
Thank you for your time, Doctor.

Ms. Chen, 40~49 year old female. Ask Date: 2020/12/11

Dr. Chen Yongxue reply Orthopedics

1.
Do I need to elevate my leg while sleeping? Answer: If possible, the affected limb should be elevated to reduce swelling, not just during sleep.

2.
When should electrical therapy for rehabilitation be initiated? Answer: Electrical therapy can be started once the fracture has initially healed and you are able to bear weight.

3.
If I walk slowly to the supermarket to buy things, will the good leg slow down? Answer: It is recommended to keep the fractured leg immobilized and avoid weight-bearing, so if possible, please use a cast and move with crutches under your armpits.

4.
How much longer will it take to heal and be able to walk normally? Answer: The time for immobilization and avoiding weight-bearing should be at least six weeks for initial healing.

Reply Date: 2020/12/11

More Info

Fifth metatarsal fractures are common injuries, particularly among individuals who engage in physical activities or sports. Understanding the symptoms, recovery process, and care for this type of fracture is crucial for effective healing and return to normal activities.

Symptoms of Fifth Metatarsal Fractures
The symptoms of a fifth metatarsal fracture typically include:
1. Pain: This is often localized to the outer side of the foot, where the fifth metatarsal is located. The pain may worsen with weight-bearing activities or when touching the area.

2. Swelling: Swelling around the fracture site is common and can extend to the surrounding areas.

3. Bruising: Discoloration may appear due to bleeding under the skin, which is a result of the injury.

4. Difficulty Walking: Patients may experience difficulty in walking or standing, often shifting their weight to avoid putting pressure on the injured foot.

5. Instability: In some cases, there may be a feeling of instability in the foot, especially if the fracture is severe.

Recovery Process
The recovery process for a fifth metatarsal fracture can vary based on the severity of the fracture and the treatment approach. Here are some general guidelines:
1. Initial Care: Immediately after the injury, it is essential to rest the foot, apply ice to reduce swelling, and elevate the foot to minimize discomfort. Avoiding weight-bearing activities is crucial during the initial healing phase.

2. Medical Evaluation: As you did, seeking medical attention for an X-ray is vital to confirm the fracture and determine the appropriate treatment. In cases where the fracture is stable, a walking boot or stiff-soled shoe may be recommended instead of a cast.

3. Follow-Up: Regular follow-up appointments are necessary to monitor the healing process through X-rays. Your doctor will assess the fracture's healing and determine when you can gradually return to normal activities.

4. Rehabilitation: Once the doctor confirms that the fracture is healing, physical therapy may be recommended. This can include exercises to improve strength, flexibility, and balance. Electrical stimulation therapy may also be utilized to promote healing.

Care and Precautions
1. Elevation: While it may not feel comfortable, elevating the foot while sleeping can help reduce swelling. You can try different positions or use pillows to find a comfortable elevation that still helps with swelling.

2. Gradual Weight Bearing: As you recover, gradually increasing your activity level is important. Start with short walks and gradually increase the distance as tolerated. It’s normal for the good foot to feel slower initially, but this should improve as you regain strength and confidence in the injured foot.

3. Monitoring Symptoms: Pay attention to any sudden increases in pain or swelling, as these could indicate complications. If you experience sharp pain or a feeling of instability, it’s crucial to consult your healthcare provider.

4. Footwear: Wearing supportive footwear is essential during recovery. Avoid slippery surfaces and ensure that any shoes or boots you wear provide adequate support to prevent further injury.

Timeline for Recovery
The timeline for recovery from a fifth metatarsal fracture can vary. Generally, most fractures heal within 6 to 8 weeks, but this can depend on factors such as the fracture's location, your overall health, and adherence to treatment protocols. During this time, it’s essential to follow your doctor’s advice regarding activity levels and rehabilitation exercises.

In conclusion, while fifth metatarsal fractures can be painful and limit mobility, with appropriate care and rehabilitation, most individuals can expect a full recovery. It’s essential to listen to your body, follow medical advice, and gradually return to your normal activities to ensure a successful healing process. If you have any concerns or experience unusual symptoms, don’t hesitate to reach out to your healthcare provider for guidance.

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