Fifth Metatarsal Fractures: Symptoms, Healing, and Weight Bearing

Fifth metatarsal fracture

I sustained a non-displaced fracture at the base of my fifth metatarsal on February 7th, with a blurred fracture line.
I still experience some pain when I get up in the morning and walk.
My ankle tends to swell more with walking and standing.
Is this a normal phenomenon? Is there an issue with the bone? Can I bear weight? Can a tendon or ligament be torn with a fifth metatarsal fracture? If torn, what symptoms would I experience? Sometimes I feel pain when stepping on a protruding object.
Why is this happening? Thank you for your response.

Feng Qiu Shuang Qing, 20~29 year old female. Ask Date: 2014/05/20

Dr. Chen Yongxue reply Orthopedics

A fracture at the base of the fifth metatarsal typically does not require surgical intervention and can heal with conservative treatment.
As mentioned in the correspondence, since the fracture occurred over three months ago, it should have healed by now.
During the healing period, prolonged standing or walking may lead to swelling due to blood circulation issues, but this condition should gradually diminish over time.
Regarding the mention of concurrent tendon and ligament injuries associated with the fracture, based on mechanical principles, such injuries should not occur simultaneously unless the mechanism of injury was extremely forceful.
In my opinion, this is a natural process, and with time, improvement is expected.
If there are still concerns regarding the fracture, please consult your attending physician.
Thank you.

Reply Date: 2014/05/20

More Info

Fifth metatarsal fractures are common injuries, particularly among athletes and individuals who engage in high-impact activities. Understanding the symptoms, healing process, and weight-bearing considerations is crucial for effective recovery.

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, particularly around the base of the fifth metatarsal. Pain may worsen with weight-bearing activities, such as walking or standing.

2. Swelling: It is common to experience swelling around the fracture site. This can lead to discomfort and may make it difficult to wear shoes.

3. Bruising: Discoloration may occur around the injury site, indicating bleeding under the skin.

4. Tenderness: The area around the fracture will likely be tender to touch, and pressing on the bone may elicit pain.

5. Difficulty Walking: As you mentioned, walking may cause pain, particularly when you first get out of bed in the morning or after prolonged periods of rest.

Healing Process
The healing time for a fifth metatarsal fracture can vary based on several factors, including the fracture's location, the individual's age, overall health, and adherence to treatment protocols. Generally, non-displaced fractures (those without significant misalignment) can take about 6 to 8 weeks to heal. During this time, it is essential to follow your healthcare provider's recommendations regarding weight-bearing and activity levels.

Weight Bearing Considerations
In the case of a non-displaced fifth metatarsal fracture, your doctor may recommend a period of rest and limited weight-bearing. It is crucial to listen to your body; if walking causes significant pain, it may be a sign that you are putting too much stress on the healing bone.
1. Partial Weight Bearing: Initially, you may be advised to use crutches or a walking boot to minimize pressure on the injured foot.
2. Gradual Return to Weight Bearing: As healing progresses and pain decreases, your doctor may allow you to gradually increase weight-bearing activities.
3. Monitoring Symptoms: If you experience increased pain, swelling, or any new symptoms, it is essential to consult your healthcare provider.

Tendon and Ligament Injuries
While a fifth metatarsal fracture primarily affects the bone, it can also impact surrounding soft tissues, including tendons and ligaments. If a tendon or ligament is injured, symptoms may include:
- Increased Pain: Pain may be more diffuse and not limited to the fracture site.

- Instability: You may feel that your foot is unstable or that you cannot bear weight without discomfort.

- Swelling and Bruising: More extensive swelling or bruising may occur if soft tissues are involved.

If you suspect a tendon or ligament injury, it is crucial to seek medical evaluation. Imaging studies, such as an MRI or ultrasound, may be necessary to assess the extent of the injury.

Conclusion
In summary, experiencing pain and swelling after a fifth metatarsal fracture is common, especially during the initial healing phase. It is essential to follow your healthcare provider's advice regarding weight-bearing and activity levels. If you have concerns about the healing process or experience worsening symptoms, do not hesitate to reach out for further evaluation. Proper management and adherence to treatment protocols will help ensure a successful recovery and return to normal activities.

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