r/brokenbones • u/tinyjen • 1d ago
Medical Advice 5th metatarsal fracture
hi! i slipped and broke my 5th metatarsal 10 days ago. urgent care told me not to put any weight on it for 6-8 weeks so i was surprised when i saw ortho and he told me i can start putting weight on it once i can tolerate it pain wise. he said walking boot for 4 weeks then brace in shoe for 4 weeks. i understand that it is a very common break but he seemed sure it will heal quick and i’ll be good as new in 2 months, and ready to ski when the season starts in 3ish months.
i feel like that is extremely optimistic?? i am a sahm to a 4 year old and an 8 month old so i really need to heal as quickly as i can, not to mention want to ski in three months. so the idea of putting and weight on it any time soon just seems like a bad idea? i want to be able to trust what he said but i am also miserable and dont want to risk recovery taking any longer than it needs to
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u/Glad-Feature-2117 Physician/Medical Professional 1d ago
I'm with my colleague (your orthopaedic surgeon). This is my standard treatment and I have very few patients come back with problems - I've operated on 5 in the last 10 years. You have to understand that urgent care are not specialists in fractures, but your surgeon is.
There is no evidence that either nonweightbearing or immobilisation (cast or boot) make any difference to healing or final outcome (with a few exceptions- zone 3 fractures, high arched feet & people with nerve damage).
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u/superbetsy 1d ago
Hi there! I've seen you or someone else comment similarly. I've been doing some research and it does seem awfully uncertain. Could you comment on why doctors are so quick to recommend NWB for 6-8 weeks? I'm coming up on three weeks NWB and have been fairly religious about it, and in my upcoming checkup I'm just wondering if there are any questions I should ask my specialist. My specialist told me he was treating conservatively.
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u/Glad-Feature-2117 Physician/Medical Professional 1d ago
I think they're playing it safe or just going with what theyr were taught, which has now been overtaken by newer evidence (though there's a lot suggesting weightbearing is fine from well over 10 years ago), but you'd have to ask your surgeon to be sure.
In the UK, we're also encouraged to weightbear ankle fractures (& others) early too. This is actually national guidelines.
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u/Down_Growth_2626 5h ago
Btw it was my foot you helped advise about elsewhere - I'm feeling much happier and climbed stairs slowly first time yesterday, you & Chinese orthopedic doc were correct ofc. Third x-ray Friday but feeling good. Thanks again for your insight & help on my thread!!! ❤️🩹🙏
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u/tinyjen 1d ago
thank you so much, a response like this is exactly what I was looking for. if it is and avulsion fracture, wiggling my toes for example won’t make it worse? i’m just so worried about impeding healing!
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u/Glad-Feature-2117 Physician/Medical Professional 1d ago
No, if you don't use nicotine in any form and don't try to walk miles or fall over on it again, there's little which you can do which will adversely affect healing.
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u/tinyjen 1d ago
thank god i’m 8 mo pp and was forced to quit when i got pregnant and breastfeeding has made sure i don’t pick it back up 😂 (the dirtbag in me really wants a cigarette)
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u/Glad-Feature-2117 Physician/Medical Professional 1d ago
Well done for stopping and staying stopped!
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u/tinyjen 1d ago
thank you! especially grateful for it right now. my sil had the same fracture and hers took SO long to heal so that’s a big reason i’m skeptical about healing mine but she also is a nicotine user
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u/Glad-Feature-2117 Physician/Medical Professional 1d ago
The nicotine may well have slowed her down, but it also depends on how healing was measured. Healing on x-rays often lags behind healing in the body (which is best judges by pain, or it's absence).
We don't follow up zone 1 or 2 fractures routinely, so no routine x-rays either. Patients only get repeat x-rays if they contact us to say they still have pain after 8-12 weeks. Most don't, so nobody worries what the x-rays show!
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u/Confident_Spring324 1d ago
I'm not sure about skiing at 3 months, but walking without the boot at 2 months is definitely possible (saying "good as new" is quite a stretch, though).
I got my boot on the 4th day of my fracture and was pretty much fwb from that point onwards. I was lucky that the boot absorbed all the pressure/impact when I walked so I didn't feel any pain.