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Fracture of 5th metatarsal
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I fractured my 5th metatarsal 6 weeks ago while running (result of ankle sprain). Initial x-rays are shown in this post. The orthopedic surgeon classified it as an avulsion fracture, although I believe the fracture does extend into my tarsometatarsal joint making this a pseudo-Jones fracture? The doctor recommended non-surgical treatment, and was not concerned about bone displacement. I have been in a walking boot/air cast the entire time, walking some but careful not to put any weight on the outside of my foot.

My most recent set of x-rays showed minimal healing (sorry, I do not have the most recent image to post), and my foot does not feel any better. Swelling and pain are still present. The surgeon has recommended that I continue to wait and wear the boot, and is confident that it will heal on its own in time. I'm concerned about the slow rate of healing, and I do not want to be negatively impacted in the future. I still intend to run and train as before the injury. For others who have had this injury (or treated it), does this seem like the best approach? I'm considering if I should just ask the surgeon to perform ORIF in an attempt to accelerate the timeline.

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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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I had a similar injury in 2008 and I was in a cast and using crutches for seven weeks in order to keep weight off of the foot and to allow to bone to fuse. Perhaps you should ask your doc if you should refrain from putting weight on that foot, even with the boot on. It's best to avoid surgery unless it's absolutely necessary. It does seem unusual that you are still experience swelling, though. I know similar posts to yours have popped up on this forum in the past..

Good luck with healing.

Jim

Here you go.

http://forum.slowtwitch.com/...time&x=0&y=0
Last edited by: jimmy d: Nov 8, 14 15:28
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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Many more specialists (NOT general orthopedists) are getting more aggressive with these larger avulsion fractures and recommending ORIF at presentation (especially in athletes) since it shortens healing time so much. I have been an advocate of it for quite some time. But, these DO almost always heal in time (unlike a true Jone's fracture where the incidence of non-union is much higher). So at this point (6 weeks in), I'd probably wait it out as well since ORIF at this time would be at least 6 more weeks post surgery anyway.

*** for others reading/education: ORIF = Open Reduction Internal Fixation (i.e. screw, plate, wire) surgery

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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I am a sports med Ortho, but not foot and ankle and don't treat these. To me, that looks like it is zone 2 and extending into the 4th-5th metatarsal joint making it a Jones fracture. It looks larger than a typical avulsion fracture. Can't say for certain given that I am only seeing one view though.

Jones take about 12 weeks to heal and many recommend to be non-weight bearing. Many do recommend early surgery. But given you are already 6 weeks out probably best to give it more time to see if it will heal on its own.

My best recommendation is to see a foot and ankle orthopedic specialist if you haven't already. Note that I am saying orthopedist who spealizes in foot and ankle, not a podiatrist.
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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Sadly I've been there twice. Same foot. Two different years. First took 14 weeks. Second took 11 weeks. Those dates are when I could do short runs. It still hurt and was sore after runs. For many weeks after getting back to running. If you bike expect even longer healing time. I rode with the first one. Not the second one. It did heal quicker with no biking. There is so little blood flow that there is really nothing that heals it quick. Best of luck. I swam a lot with a pull buoy and only used the other foot to push off the wall.
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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Are you 100% sure that you don't need surgery? Yours look more displace than mine back in 2012 so keep that in mine. I was swimming the next week and cycling by week three. Running started in week 9 and I was up to 30 miles per week (running) by week 12. An x-ray would probably still show a fracture but I'm not experiencing any pain (none really) so I never pushed for surgery.

I purchased a ultrasound bone stimulator online (ebay) to help with blood flow. You can google guides on what to look for when buying them (second hand) online. Also, by week three I ditched the walking boot (Hoka's are the same height by the way if you want to even out your hips) and purchased some super-stiff mountaineering boots (stiff enough to take a full cramp-on). This gave more mobility than the "boot" yet was just as supportive and protective. I was walking up to 60 minutes in these boots by week 6.

Good luck!
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Re: Fracture of 5th metatarsal [DC Pattie] [ In reply to ]
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Thanks to everyone for the comments and input. After googling for info multiple times, it's a relief to get advice about my specific injury.

At this point I do intend to continue with non-surgical treatment and use the walking boot, as recommended by my doctor. For everyone's info, I have been seeing a orthopedic surgery who specializes in sports medicine, especially ankles and feet. I also intend to ask about both crutches and bone stimulation. My doctor didn't indicate that I completely need to stay off of my foot, but I think it is worth asking. As for bone stimulation, I know that my doctor said it was an option to consider if healing took a very long time (insurance would cover it after 12 weeks).
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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I fractured my 5th metatarsal December 6, a true jones fracture which required surgery with a screw put in. First 3 weeks after surgery no weight and on crutches. Last 2 weeks In a walking boot and no more visible swelling. Hoping to be out of boot next week. How's your recovery? Hoping to run again first week in March, which will be 12 weeks post op.
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Re: Fracture of 5th metatarsal [rubyv55303] [ In reply to ]
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I fractured 5th metatarsal of my right foot January 5th 2014. Same thing avulsion fx etc. Surgery not recommended. I was in a boot and crutches and eventually just weaned myself off and walked with a limp. My doctor said 8 weeks no running but sometimes they can take a while to heal.
The last time I went to see him at exactly 8 weeks out and although it wasn't yet completely healed he said that I could start running if it didn't hurt. I did carefully at first but I was running 8 miles in a few weeks.
It's all good now. No lingering effects.
Good luck. Don't worry. I did.
Last edited by: Ty: Jan 10, 15 17:28
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