Rehabilitation After First Metatarsal Fracture Surgery: What to Expect

Rehabilitation for First Metatarsal Fracture

Due to a car accident, I underwent surgery for a fracture of the first metatarsal bone.
The procedure was named: "Open reduction and internal fixation of the left foot tarsometatarsal joint dislocation with fracture." The reason for the surgery was the dislocated fracture.
The surgeon mentioned that the operation went very smoothly, and there is a high chance I will be able to run in the future.

I have a few questions for Dr.
Chen:
1.
Six weeks post-surgery, the doctor reviewed my X-rays and said my recovery looks good.
He mentioned that I can wear a pneumatic walking boot.
However, I experience significant pain in my heel while walking, although the area where the metatarsal was operated on does not hurt.
Is this normal?
2.
While wearing the pneumatic ankle boot, how many weeks should I expect before I can walk normally without pain?
3.
What can I do to speed up my recovery and walk normally sooner? Should I consistently wear the pneumatic boot and walk more, or consider physical therapy, or are there other options?
4.
Will there be any long-term complications from this surgery?
5.
During the surgery, two absorbable screws were placed.
Will I need to have them removed later, or will they be absorbed by my bone and disappear on their own?
I apologize for the interruption, Dr.
Chen.

Mr. Jiang, 30~39 year old female. Ask Date: 2023/02/04

Dr. Chen Yongxue reply Orthopedics

Heel pain is temporary and related to a period of not walking properly.
Please apply heat therapy frequently.
Stretching, as tolerated, will help improve the condition.
The absorbable bone screws do not need to be removed.
Thank you.

Reply Date: 2023/02/04

More Info

Rehabilitation after a first metatarsal fracture surgery is a critical process that requires careful management and patience. Given your situation, where you underwent surgery for a dislocated and fractured first metatarsal, it’s essential to understand what to expect during your recovery and rehabilitation journey.

1. Post-Surgery Pain and Recovery: It is common to experience pain in the heel or the area surrounding the surgery site, especially when you start to walk again. The fact that your doctor noted good recovery on the X-ray at the six-week mark is encouraging. However, pain in the heel while walking can be attributed to several factors, including the adjustment of your foot mechanics after surgery, inflammation, or even the pressure from the air-cushioned boot. It’s essential to communicate this pain to your healthcare provider, as they may need to adjust your rehabilitation plan or provide additional pain management strategies.

2. Timeline for Normal Walking: The timeline for returning to normal walking without pain can vary significantly among individuals. Generally, after surgery for a metatarsal fracture, patients may expect to gradually increase their weight-bearing activities over several weeks. Many patients can start walking without crutches or a boot around 6 to 8 weeks post-surgery, but this can depend on the specific nature of the fracture and your overall health. Your healthcare provider will guide you on when it is appropriate to transition to normal footwear.

3. Accelerating Recovery: To speed up your recovery, it is crucial to follow your rehabilitation plan closely. This may include wearing the air-cushioned boot as prescribed, engaging in physical therapy, and performing specific exercises to improve strength and flexibility. Gentle range-of-motion exercises can help maintain mobility in your foot and ankle. Additionally, modalities such as electrical stimulation or ultrasound therapy may be beneficial, but these should be discussed with your physical therapist. Consistent, gradual weight-bearing activities, as tolerated, will also aid in your recovery.

4. Potential Long-Term Effects: After a metatarsal fracture, some patients may experience long-term effects such as stiffness, chronic pain, or changes in foot mechanics, which could lead to issues like arthritis in the joint. However, many individuals recover fully and can return to their previous activities, including running. Regular follow-ups with your orthopedic surgeon will help monitor your recovery and address any concerns about long-term effects.

5. Absorbable Screws: Regarding the absorbable screws used during your surgery, these are designed to dissolve over time and do not typically require removal. They will gradually be absorbed by your body, which means you won’t have to undergo another procedure to take them out. Your surgeon will monitor the healing process through follow-up appointments and imaging to ensure everything is progressing as expected.

In conclusion, your rehabilitation after first metatarsal fracture surgery will involve a combination of rest, gradual weight-bearing, and physical therapy. It’s essential to listen to your body and communicate any concerns with your healthcare provider. With diligence and proper care, you can expect to return to your normal activities, including running, in due time. Always remember that recovery is a journey, and it’s important to be patient with yourself as you heal.

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