Post-Surgery Recovery Insights for Fifth Toe Fracture: What to Expect - Orthopedics

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Postoperative care for fifth metatarsal fracture?


Hello Doctor: I recently suffered a fracture of the fifth metatarsal and underwent surgery, using absorbable screws.
In the fourth week, the doctor said I could start walking.
Now, in the fifth week, there is no significant pain at the fracture site, but my toe and the top of my foot are still swollen.
However, I experience pain on the outer side of my ankle when bearing weight, and there is bruising on the inner side.
Is this situation normal? How much longer will it take until I can walk normally? Thank you, Doctor.

Huang Hong, 20~29 year old female. Ask Date: 2023/12/30

Dr. Chen Bochen reply Orthopedics


It is quite common to experience the symptoms you mentioned when you first start walking, but they usually resolve after walking for a while.

Reply Date: 2023/12/30

More Info


Post-surgery recovery from a fifth toe fracture can vary significantly from person to person, depending on the severity of the fracture, the surgical technique used, and individual healing responses. It’s great to hear that you are in your fifth week post-surgery and that you are experiencing minimal pain at the fracture site. However, the swelling in your toe and the pain on the outer side of your ankle are concerns that warrant further discussion.

Firstly, it is not uncommon to experience swelling and bruising after surgery, especially in the initial weeks of recovery. The body’s inflammatory response to surgery can lead to localized swelling, which may take several weeks to resolve. The fact that you are not experiencing significant pain at the fracture site is a positive sign, indicating that the healing process is likely progressing well. However, persistent swelling and bruising can indicate that the area is still healing or that there may be some residual inflammation.

The pain you are experiencing on the outer side of your ankle could be due to several factors. It may be related to compensatory movements you are making to avoid putting pressure on your fifth toe, which can lead to strain or discomfort in other areas of your foot and ankle. Additionally, if you have been favoring your foot, it could lead to overuse injuries in other parts of your foot or ankle. It’s essential to monitor this pain and discuss it with your physician, as they may want to evaluate your gait and how you are bearing weight on your foot.

As for your question about how long it will take to return to normal walking, this can vary widely. Generally, after a toe fracture, patients can expect to gradually return to normal activities within 6 to 8 weeks, but this timeline can be influenced by several factors, including the extent of the fracture, the surgical technique used, and your overall health. Since you are already in your fifth week and have begun walking, you are likely on the right track. However, it’s crucial to listen to your body. If you experience increased pain or swelling, it may be a sign that you need to take a step back and allow more time for healing.

In terms of rehabilitation, gentle range-of-motion exercises can be beneficial in promoting flexibility and reducing stiffness in the toe and surrounding areas. However, these should be done under the guidance of a physical therapist or your physician to ensure that you are not overexerting yourself. They can provide you with a tailored rehabilitation program that considers your specific situation.

Finally, if the swelling and bruising do not improve or if the pain in your ankle persists, it would be wise to follow up with your healthcare provider. They may recommend imaging studies, such as an X-ray, to ensure that there are no complications, such as a misalignment or additional injury that may not have been apparent initially.

In summary, while some swelling and discomfort can be normal during the recovery process, it is essential to monitor your symptoms closely and communicate with your healthcare provider about any concerns. With appropriate care and rehabilitation, you should be able to return to normal walking and activities in the coming weeks.

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