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Treatment for fractured METATARSAL BONE after fall.

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Dear orthopedic surgeon,

My name is Dimitri and I am a healthy, 25 year old man who never had any health problem, doesn't have any medical condition and never broke any bone - until Sunday 17 May 2015.

I jumped from a 1m high pole and landed on the side of my left foot instead of my sole and fractured my 5th metatarsal bone. As you can see in the attachment, my bone is clearly fractured but not displaced. I can rotate my ankle and move all my toes with minimal pain, but the junction between my foot and my toes is bruised.

I could not get a cast right after the accident happened so I only wore a soft bandage before getting a second X-Ray 36 hours later at BIMC hospital in Bali (on Tuesday 19 May), Indonesia. I received an L-shaped cast covering my sole and going up halfway through my calf. The calf is wrapped around my foot with a bandage.

I am scheduled to return to the hospital for a check up evaluation in about 2 weeks but I would like to have a second opinion.

-How long should I be keeping the cast? The two general practicioners I met suggested 2-4 weeks, but patients with similar fractures in online forums recommended 4-6 weeks.

-I am currently avoiding putting any pressure on my injured foot. That said, I heard that some exercise might be able to stimulate bone recovery. When should I start putting some weight on my left foot, and if so, what exercices should I start implementing?

-Besides getting some rest, is there anything else I can do to obtain the best recovery results? (types of food, cold or warm compress etc.)

Thank you for your help. This is my first fracture and I am worried that I will not be able to exercise the same way in the future because of it so I would like to do anything I can to heal well.

Sincerely,
Dimitri Tran

P.S: I did not provide a real email address and passcode when testing out the website and a bug in the website prevented me from changing my email address when I finally decided to use your services. Therefore I will not be able to receive your response if it is sent to the existing email. My actual email is [email protected] .

I have already emailed the website support team but I would appreciate it if you could CC the team as well at [email protected] so they know that this is my real identity. Thank you.

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 29 Doctors Online

Hello Dimitri,
Thank you for your query at DoctorSpring.com
I have read your question with diligence.It will be my pleasure to help you.First of all i will tell you that please do not worry.
Your answers are following-
-You should wear the cast for about 4-6 weeks.This will eliminate any chances of non union of bones.
-You should start partial supported weight bearing on your limb after 4 weeks with help of crutches.
-You should neither smopke nor drink excessively.
-The weight bearing of partial nature will be helpful in stimulasting bone healing.
-You should take dairy products like milk ,cheese,curd to enhance bone recovery.
This fracture does not looks to be a major one & has good chances of healing.
After complete recovery you may be able to move & work as normal person.
With best wishes.


Patient replied :

Dear Dr. Mukesh Tiwari,
Thanks for your prompt answer.
I will follow your advice and keep the cast for 4 weeks then, while not putting any pressure on the foot for the next few weeks. I will start weight bearing progressively in 3 or 4 weeks.
I just had one last question for now:
I was told to take Advil ibuprofen tablets to reduce the inflamation (400-800mg a day) but I wasn't told when I should stop taking those. I started taking Advil on Monday 18 May; so when should I stop?
Also, should I apply Voltaren cream, or hot or cold compress on my foot every day?
I will follow up with you in 2-3 weeks after I get another X-Ray done and send you the picture so you can track my recovery process.
Thanks again for your help.
Best,
Dimitri Tran


Hello,
I won't recommend any Voltaren or hot or cold compresses.
Continue the Advil till your next x-ray and let me review.
Regards.


Patient replied :

Dear Dr. Mukesh Tiwari,
I returned to the hospital to get an X-Ray done and meet with an orthopedic surgeon (see attachment).
The specialist says that my fracture is healing well, although it won't show in the X-Ray until 3 months after the incident. The bone is still in a good position. I feel less pain each day and, when the doctor pressed on my foot, I only felt a slight discomfort but no real pain.
He prescribed me some ossein hydroxyapatite to promote bone strenghtening (800mg/day for 10 days) and recommended me to start putting some weight on my foot next week (3 weeks after I put on the cast and 23 days after the incident). He added that I should stop if I feel some pain. Do you think it would be ok for me to start walking a little bit each day starting next week?
Also, do you think I could try snorkeling (using fins/flippers attached to my feet) in 5 weeks time? It will have been 7.5 weeks after the fracture happened. Of course, I would only try if I feel no pain and I will not push myself too hard.
Best,
Dimitri Tran


Hello Dimitri,
Yes you may have partial weight bearing from next week.You should also avoid weight bearing if you feel pain.
You may wear non slippery sandals .
Hope this will help you.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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