Persistent Bruising After Metatarsal Fracture: Should You Be Concerned?

The bruising from a metatarsal fracture is slow to resolve?

I sustained fractures of the first, second, and third metatarsals on August 18.
The X-ray showed only slight displacement of the third metatarsal, while the others were non-displaced.
The doctor indicated that it was not a concern and applied a fiberglass splint with elastic bandage for stabilization.
During a follow-up appointment a month ago, the doctor mentioned that I should be able to remove the splint on October 8.
At that time, I had a bruise on the sole of my foot that was about three centimeters in size, which had not yet faded.
When I asked the doctor about it, he did not examine it and said it was not a concern.

Next Friday, I have another follow-up appointment, but that bruise has not lightened at all, while the other bruises on my foot have resolved.
Additionally, there is still some redness and swelling on the dorsum of my foot.
I would like to know if the bruise indicates that there may still be internal bleeding or that the fracture has not healed.
I have upcoming work commitments and am worried; should I schedule an earlier follow-up appointment? Thank you for your assistance, Doctor.

Ms. Hsieh, 50~59 year old female. Ask Date: 2015/09/29

Dr. Shi Guozheng reply Orthopedics

After a fracture, there will be bleeding, which typically leads to bruising that will resolve on its own after some time and is unrelated to the healing of the fracture.
Fractures of the metatarsal bones usually heal within two to three months.

Reply Date: 2015/09/29

More Info

Persistent bruising after a metatarsal fracture can indeed be concerning, especially if the bruising does not seem to be resolving as expected. In your case, you mentioned that you sustained fractures in the first, second, and third metatarsals on August 18, and while the X-rays indicated that the fractures were stable, you still have a significant bruise on the bottom of your foot that has not faded after a month.
Bruising occurs when small blood vessels are damaged, leading to bleeding under the skin. In the context of a fracture, it is common to see bruising around the injury site due to the trauma and the body's response to the injury. However, persistent bruising, especially if it is accompanied by swelling or pain, can sometimes indicate that there is ongoing bleeding or that the healing process is not progressing as it should.

Here are some points to consider regarding your situation:
1. Healing Process: The healing of fractures can vary significantly from person to person. While some bruising is normal, especially in the initial weeks following an injury, bruising that remains unchanged for an extended period may warrant further investigation.
2. Signs of Complications: If the bruise is accompanied by increased pain, swelling, or changes in sensation (such as numbness or tingling), these could be signs of complications such as compartment syndrome, which is a serious condition that occurs when there is increased pressure within a muscle compartment. This can lead to decreased blood flow and potential muscle and nerve damage.

3. Follow-Up Care: Since your doctor previously indicated that the bruising was not a concern, it is essential to trust their expertise. However, if you feel that the bruise is not improving and you have concerns about your recovery, it is perfectly reasonable to seek a follow-up appointment sooner than scheduled. It is better to err on the side of caution, especially if you have upcoming work commitments that may be affected by your recovery.

4. Monitoring Symptoms: Keep an eye on the bruise and any other symptoms you may experience. If you notice any changes, such as increased size of the bruise, new areas of bruising, or worsening pain, these are important to report to your healthcare provider.

5. Rest and Rehabilitation: Ensure that you are following your doctor's recommendations regarding rest and rehabilitation. Avoid putting weight on the injured foot until you receive clearance from your doctor. Engaging in physical therapy or rehabilitation exercises, as advised, can help facilitate healing and restore function.

In conclusion, while some bruising is expected after a fracture, persistent bruising that does not improve over time should be evaluated. If you have any doubts or concerns about your healing process, do not hesitate to reach out to your healthcare provider for further evaluation. It is always better to be proactive about your health, especially when it comes to recovery from an injury.

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