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Fractured fifth metatarsal

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Created by ezza > 9 months ago, 29 Jan 2014
ezza
NSW, 561 posts
30 Jan 2014 2:07AM
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Hey SBers,
i've gotten myself a pretty nasty double fracture at the base of the fifth metatarsal left foot. Has anyone had this injury? Would appreciate advice on recovery times and exercises to do to maintain strength in that leg (cannot weight bear).
Go?.

Dave Whettingsteel
WA, 1289 posts
30 Jan 2014 7:11AM
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Youch! I'm 5 weeks into recovering from a back injury, I don't have any advice on recovery time for you, but on the mental side, keep positive, stay involved with the kiting scene and do all the exercises etc the docs recommend. Twice if you can. Track improvement, so you can believe you are going to return to full health.

All the best!

steezy
VIC, 46 posts
30 Jan 2014 12:40PM
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Painful stuff. Can't speak for the a foot injury, but i fractured my metacarpal bone in my hand on my ring finger into 3 pieces.
I'm currently 10 weeks out of surgery and have been advised from the physio to stay out of for another 5 weeks.
In saying that my bone was completely shattered where as a clean break would normally be closer to a 6 week recovery.

LuigiKiter
WA, 172 posts
30 Jan 2014 10:32AM
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Select to expand quote
ezza said..

Hey SBers,
i've gotten myself a pretty nasty double fracture at the base of the fifth metatarsal left foot. Has anyone had this injury? Would appreciate advice on recovery times and exercises to do to maintain strength in that leg (cannot weight bear).
Go?.


Hi Ezza, sorry to hear.. one quick question how did you broke it? Kiting? Im asking because I had a nasty foot injurie when my kiteboard skid out from my foot.

ezza
NSW, 561 posts
30 Jan 2014 3:48PM
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Hey thanks for the advice. @EternalNoob? I wish I could say it was doing something extreme but I was just taking out the recycling and turned my ankle on the kerb. It's basically an avulsion injury where the ligament yanks off the end of the bone but I had an existing stress fracture they think which also blew at the same time a little higher up the bone. I find out wednesday if I need to have surgery.

cauncy
WA, 6023 posts
30 Jan 2014 1:24PM
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Select to expand quote
steezy said..

Painful stuff. Can't speak for the a foot injury, but i fractured my metacarpal bone in my hand on my ring finger into 3 pieces.
I'm currently 10 weeks out of surgery and have been advised from the physio to stay out of for another 5 weeks.
In saying that my bone was completely shattered where as a clean break would normally be closer to a 6 week recovery.


on the mental side dave, do you sit on the verandah with your back to the ocean not watching people kite, ive picked up plenty of injuries and watching kiting sucks when you carnt, infact ive only just got over smacking my ribs on a mooring buoy at a secret kiting location that you know

danw
WA, 158 posts
30 Jan 2014 2:04PM
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Hey man, sorry to hear about that injury. Your looking at about 6-10 weeks of non-kiting, this is the time required for the bones to get union between the fractured ends. Before you get kiting you should 1) make sure your doctor/physio is happy with the bone union on x-ray 2) be relatively pain free putting your full weight through the foot on a double or single leg jump. (first try a double leg squat than single leg finally with a jump) as this will replicate the kind of impact you will be doing on a kite. Remember if its painful, its your body telling you its not ready for what your doing.

Best thing to do is supplement your kiting time with other activities. I.e gym for the other joints, earning brownie points, catching up with people. Whatever will make the time go by fast. Have a speedy recovery.

Dan

tightlines
WA, 3089 posts
30 Jan 2014 4:35PM
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Become a kite bitch.

Launch and land kites, buy a camera and take photo's of the rest of the crew, they will love you for it.

Juddy
WA, 1040 posts
30 Jan 2014 5:33PM
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^^^^

what Tightlines said.

If you knew of his recent run of luck (and it's been far, far, far from being called "good luck") you'd have to agree....

stuntnaz
NSW, 540 posts
30 Jan 2014 8:49PM
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Sorry about your foot mate ! I broke my foot kitesurfing last year



I went hard on the rehab and was back on the water in 6 months
the doctors said around a year . First I did heaps of stretching and
Getting strength back in my foot with elastic in the couch time ,2 waist deep in a pool walking 3 swimming at the beach pool everyday watch out walking on sand kills 4
Body boarding with a flipper on good foot nothing on bad foot. .
Worked for me now it's like I never broke it .
Hope all goes well and your back on the water soon

wdric
NSW, 1616 posts
30 Jan 2014 9:53PM
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Juddy and tightlines have some good ideas, probly best to do in Newy

I did three of those back in dec 2011,
Almost followed docs orders, but started to ride bike a couple of weeks before the boot came off and had the weight on my heel only and tried to relax the rest of the foot.

otherwise you just gotta suck it up, before you know it the boot will be off and it will be a distant memory

ezza
NSW, 561 posts
31 Jan 2014 1:12AM
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@tightlines the local crew have already put me on camera duty! though seeing it's my left foot I can't drive my van so I require chauffeur service between my house and the beach

@stuntnaz you got some metal in there! my fracture is in two places so I find out on monday if i need to get a pin put in. i'm praying for a nice union of the bones but an x-ray at 2 weeks showed displacement and separation so its likely i will need surgery. then i'm looking at a nice 10 week recovery by which time it will be cold and windless around here.

@wdric you're a machine though? you kited 17kms with a broken foot after breaking it!

greenleader
QLD, 5073 posts
31 Jan 2014 12:33AM
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yes, gentle bike riding.....gradually ramping it up!

austin
668 posts
31 Jan 2014 8:58AM
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broke my foot skateboarding years ago and wore extra layers of socks until it was fixed....stop moaning

junglist
VIC, 700 posts
31 Jan 2014 5:47PM
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Hey

I had pretty much the same injury. I was back on the water in five weeks (had a kite holiday booked). I rushed back to the water before I was ready and suffered pain in that foot for a good six months after the accident.

Take your time coming back dude.

chino
VIC, 163 posts
1 Feb 2014 12:03AM
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My guess is probably minimum 6 weeks just to weight bear properly without a cam boot on and then another 4-10 weeks of slowly getting back into exercise and regular movement. The issue is you will probably feel a lot better after 6 weeks but if you redamage the bone or it gets displaced again, healing time will be way longer and you run the risk of having permanent pain and arthritis. There will be such a drive to try to do things early but try to resist - I kited 4 weeks after breaking my ankle and it was definitely too early. 10 weeks now and I'm finally properly ready to get back in the water.

kitebored
NSW, 549 posts
1 Feb 2014 4:21PM
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I fractured my left foot 5th metatarsal when I was about 16. Although it was a fracture it was pretty much just a thin crack and wasn't that sore. I hobbled around for a week or so and was off sport for about 6 weeks. Still gets a bit sore around the area over 10 years on, probably worth asking a physio who specialises in fracture rehab.

Sounds like your's is far worse than mine was, there's fractures and there's "fractures". I snapped my tib & fib clean/displaced and they called it a fracture - to me it was bloody broken!

I second everyone's take the time for recovery advice, I've taken 1 step forward 2 back many times rushing into activities too early.

Bike riding and swimming are low impact activities generally good for recovery. Also those cheap hot foot spas with vibration can help to get blood flowing and heal broken bones, might be worth looking into - worked well for me.

jackforbes
WA, 499 posts
2 Feb 2014 11:50AM
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Hi ezza,

Did the same thing about 4 months ago. Not as bad as you by the sounds.

I used a moon boot for the first 4 weeks or so, then used a neoprene bootie. Cycling was good, used the boot then when it got a bit better just the strap up bootie. Same for swimming, kept it strapped up but I reckon that was the biggest thing as you still use your foot quite a lot without load bearing. I was going to get out on the water after 6 weeks, but there was no wind for another couple of weeks. Glad I didn't the difference between 6 and 8 weeks was exponential.

I posted the same question when I did it, somebody suggested wake style booties - wouldn't work for me as i only ride a strapless surfboard, but would be great if you're on a TT!

drfoot
WA, 11 posts
2 Feb 2014 5:17PM
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hi ezza

this injury is often misunderstood - by your health practitioner that is

by that i mean that a few mm can mean a difference in treatment options? and there is plenty of different types of 5th met fractures!

generally 5th met fractures are susceptible to not reducing - i.e. there gap in the fracture doesn't close even if you wait the prescribed 6-8 weeks rest

the reason being that the base of the 5th met has a dynamic stabiliser muscle called peroneus brevis attached to it. the PB muscle is always firing trying to improve the structural integrity of the lateral ankle and it never rests. considering the proximity of the fracture to the PB muscle - all that movement can ensure that the edges of the fracture never get the opportunity to unite.

also - about 1cm from the base of the 5th met the common nutrient artery bifurcates to a distal route and a proximal route. if you are unfortunate enough to cop the fracture at the site of the bifurcation you could be looking at a longer healing rate than usual - in fact i think the recommendation is internal fixation for this one (surgery)? this is the one i often see in the clinic where it has been mistreated.

in fact i saw a ripper a couple of years ago where the patient busted the 5th met dancing at the buddy holly tribute concert - the snapped 5th met twisted, latched into the shaft of the 4th met and started growing sideways anchoring itself onto the wrong bone!

5th met fractures recovery often played down and underestimated - i guess its not unlike having a sore finger and for 8 weeks you pull on it 12 hours a day then it would take a lot longer to heal - the big one for treatment here is NON WEIGHTBEARING FOR 6-8 WEEKS and don't let any doc try tell you otherwise!!!!

go and see a good PODIATRIC SURGEON of reputable podiatrist that knows their stuff!

ezza
NSW, 561 posts
2 Feb 2014 9:31PM
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Hey Drfoot,

Thanks for all that useful info. I've had two x-rays now, one at the initial injury and one two weeks after (spent the intervening two weeks in a moon boot but I was weight-bearing and generally being a bit casual about it) and in the second x-ray it had separated and displaced slightly. I have type 1 diabetes too so fractures of the extremities are generally bad news unless you have very good blood glucose control. Its harder to control your BGL as well when you can't exercise.

It's not the Jones fracture I think you refer to between the base of the fifth and the diaphysis where the nutrient artery terminates; but there are 2 separate fracture lines, an avulsion right on the base and a fracture that extends across the base into the intraarticular space. The first doctor I saw was a weekend Doctor at a bulk billing medical centre and basically said I could even use a soft dressing; bandage it up and weight bear as pain allowed. It was surprisingly not very painful, especially compared to the grade 2 MCL tear I did a year ago where the pain was so bad I didn't want to put any weight on it at all for many weeks. When I saw my own Doc two weeks later he was horrified and sent me straight to get a cast. I get a progress x-ray on wednesday and if still no sign of callus forming will go to the ortho or podiatric surgeon.

You sound like you may know the answer to these questions; I don't have private health cover; would medicare cover any of the cost of having surgery? Do you know if the waiting times are very long? and finally, have you any idea of the cost involved?

Thanks :)

drfoot
WA, 11 posts
2 Feb 2014 9:56PM
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hey ezza

interesting times?. those intra articulars are a little more nasty as you can appreciate?

diabetes shouldn't really be an issue (however i do not know your situation) as long as you are youngish and well controlled? exercise - get in the pool everyday!

the avulsion fracture can't heal as per my discussion on the previous post - PB loves to tug on it at any opportunity and will prevent reduction

by the sounds it needs a internal fixation either by wiring or a pin - most of the time (and i mean MOST of the time, especially this at the base) with 5th met fractures attempting to manage them conservatively just delays the inevitable? if you know what i mean?

medicare won't cover podiatry surgery however it will cover orthos. best to consult with both - cost you $100 but its prob what you need. not sure about waiting lists or costs etc sorry?

btw if you can get that follow up X-ray in a weight bearing position it gives a much better understanding on how the fracture looks under load compared to non weight bearing - makes sense huh?.

some may boo whoo this but i love it - for a 1%er take calcium and vitamin D - both are essential for cellular repair and regeneration

feel free to PM me some X-ray pics if you feel you want to.

good luck!!

drfoot
WA, 11 posts
2 Feb 2014 9:59PM
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Select to expand quote
stuntnaz said..

Sorry about your foot mate ! I broke my foot kitesurfing last year



I went hard on the rehab and was back on the water in 6 months
the doctors said around a year . First I did heaps of stretching and
Getting strength back in my foot with elastic in the couch time ,2 waist deep in a pool walking 3 swimming at the beach pool everyday watch out walking on sand kills 4
Body boarding with a flipper on good foot nothing on bad foot. .
Worked for me now it's like I never broke it .
Hope all goes well and your back on the water soon


stuntnaz i once read a research article on calcaneal fractures from the early 1900's

the first line i will never forget 'a man who fractures his calcaneus is done'

haha - times have changed and the outcomes are surprisingly good! wow you must have really smashed it!!!

ezza
NSW, 561 posts
17 Mar 2014 9:05PM
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It's been about 12 weeks since I broke my foot in two places. I've been saintly, no alcohol (well barely any) and drinking lots of milk, taking vitamins and silica. No driving, and 9 weeks in a cast. 3 in a moon boot. I now have what they are terming a "delayed-union", which basically means the two bits of bone haven't formed a bony callus which signifies healing. There is a clear 4mm gap between the two bone ends. Fark!!!!!
The ortho wants to wait two months to 'see what happens'. If in 2 months I haven't healed then they will look at surgery. In the meantime I can't work, can't drive, although admittedly there is little pain. Has anyone been in a similar situation? I am going fully nuts.

gcdave
525 posts
17 Mar 2014 6:35PM
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In my non medcial professional opinion, put some weight on that boot. Ur prob being too careful with it, and the bones need some weight on them to mend well. 4mm still a gap tho

Loosing mobility has good days and bad, but be determined on a positive outcome and focus on it.Good luck with the mend, and stay positive. Cast off then physio, and relearn gybes. Long road ahead.Similar road im on still after 5+ months. Always next season erin

ezza
NSW, 561 posts
1 May 2014 10:24PM
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Well four months since my injury it turns out I've made next to no progress. 8 weeks in a cast, three in a boot. The advice I'm getting now is grim.. the Dr that was such a fan of 'conservative treatment' (i.e. cast immobilisation) in the beginning, is now saying that I need to have surgery. I'm kind of pissed off because at each progress X-ray the doctor (a long time friend as well as my GP of 8 years) consulted an ortho who advised continuing in the cast. I'm a student radiographer and from the beginning I thought it looked like it needed surgery but deferred to the doctor's opinion. Now I'm looking at elective surgery and another 8 weeks off work & off the water. Gutted.

inside grunt
WA, 72 posts
1 May 2014 8:50PM
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My guess is your doctor like most GP's knows fark all about feet. He than consulted with his ortho mate who doesn't specialist in feet either! That fracture needed surgery, especially after 6 weeks with no sign of union. As Dr foot said, the attachment of the peroneus brevis muscle is constantly pulling the fracture apart. Thus it needs pinning together so the two sides of the fracture unite. Consult with an ortho surgeon who specializes in foot surgery. (podiatric surgeons are not under Medicare)

hamburglar
ACT, 2163 posts
4 May 2014 6:42AM
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and who said it doesn't hurt to recycle!



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"Fractured fifth metatarsal" started by ezza