3rd and 4th Metatarsal Fractures

by Angela
(Bath, Maine)

Hello

2 months ago I fell during a seizure and my left foot smashed into an oak table and my 3rd and 4th metatarsal bones were badly fractured. I had surgery where the original plan was to put screws and plates in my foot, but during the surgery the bones begin to split when they were trying to put the screw in so they had to use titanium staples instead.
Anyway I was in a non weight bearing boot until about 2 weeks ago, I have just began putting weight on my foot using a surgical shoe and crutches but I am still having pain in my foot. My foot dr says that the fractures have healed but it is really hard to walk without the support of crutches. I am worried because dr says I should be able to walk without the crutches but it is painful and my foot is still swelling every time after I walk on my foot. Is this normal for me not to be able to walk without crutches this many weeks after surgery, and is there a preferred shoe that I should be wearing that could help me better then the surgical shoe they gave me, it's not much support?
Thank You,
Angela

RESPONSE

Hi Angela,

If my time line is correct then you are about six weeks post surgery. Let's put it this way; I would not be surprised if you were walking pain free and I am not surprised that you still have pain.
I did not see the severity of the breaks but you are right on the cusp of being healed. Normally broken bones take six to eight weeks to heal in a healthy individual. Hardware inserted into the fractured bone, generally allows weight bearing quicker, but that might be off set by the severity of the fracture(s).
Additionally, your overall health could be a factor in your body's ability to heal and at what pace. I do not know how old you are nor do I know if you smoke or have other issues that may slow down the healing process.
Just because your foot looks good on x-ray should not be the sole reason in resuming weight bearing, as your doctor also needs to note the clinical appearance of your foot. If your foot is constantly swelling it may be an indication that you are not ready to ambulate; again if I knew more about your medical history, I might be able to be more specific.
You probably need to have this conversation with your surgeon as he would be the one to best assess your situation.
If he feels there is no rational reason why you cannot bear weight for extended periods of time, then I would think a round of physical therapy might be indicated in an effort to get you better, faster.

Marc Mitnick DPM
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