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The response to the question below was authored by Marc Mitnick DPM

fracture to 3rd metatarsal

I fractured my 3rd metatarsal 3-4 weeks ago. The injury occured when I tripped over something and my foot (toes first) slammed into a solid steel box. I went to the urgent care clinic and they confirmed the break (alligned fracture). They gave me some pain killers and an "after surgery shoe" to wear (mainly because my foot was too swollen to wear my regular shoes). They told me I only needed the surgery shoe for a week. Since then, my foot has been throbbing, had incredible pain in the ball of my foot (from walking) and now on the top of my foot (almost as bad as when I broke it). The toe itself keeps re-bruising. I was told it should heal within 4 weeks and at first, it seemed to be healing well but perhaps it was more that it "felt better" then when I first broke it. Now though, it pains me all the time and it seems to be regressing with pain and bruising.

I'm wondering if I've slowed the healing process or maybe re-broken it or maybe it was more then they initially thought? Also, could there have been other stress fractures from the original injury that have worsened?

I'm pretty tough and... I'll admit I hate going to the doctor (no offense) but I'll go back to the Dr if it seems warrented.

ANSWER

Hi,

The mistake that was made was telling you that you only had to wear the surgical shoe for a week. The point of wearing that type of shoe was not because your foot was swollen, but to protect the broken bone from the stress placed on it when you walk.
In an ideal world a simple metatarsal fracture will take at least four weeks to heal, in many cases as long as eight weeks.
So, you basically walked around with a broken bone, unprotected, and that is probably the reason you are still in pain.
Your biggest concern, besides the pain, is that you did not make matters worse.
I would suggest you make an appointment with a foot specialist in your area, have a new xray to see if there was further damage. (you might want to bring the original xrays with you for comparison; you can request them) With this information available to your doctor, he or she should be able to lay out a course of treatment.

Marc Mitnick DPM
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Sep 01, 2017
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Pain from walking on the callus?
by: Jean

After a 3rd metatarsal fracture, I was instructed to wear a post-surgical boot for a total of 4 weeks, with an interim x-ray to make sure callus was forming. For weeks 5-6, I was told to wear regular shoes with rigid soles. At the end of the 6th week, with a 3rd x-ray confirming that callus surrounded the broken bone (the break still visible), I was told I could go back to the footwear of my choice. However, I now have fairly stiff pain in the bottom of the foot when walking and can feel a bony "knob" in the bottom of that foot (not on the other foot) where it hurts. The P.A. said that it's probably the thicker callus protruding. I see that it can take up to several years for the callus to be completely reformed into the original bone size. What do I do in the meantime about the pain?
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Although it certainly could be bone callus causing your pain, the way the metatarsal bones are angled, unless your fracture is at the head of the metatarsal, I am not so sure that the bone callus is causing your pain, but I am not privy to your x-rays.
If you press in the area that hurts and you can actually feel a "lump" of some sort (compared to same spot on the other foot), then yes, it may be bone callus.
The problem is, it may also still be fractured and perhaps that is causing your pain.
If your doc or the P.A. feels it is only bone callus, then using orthopedic felt you can make an accommodative pad to place on the bottom of the foot to relieve the pressure from the bone callus. Ask the doctor how to do it.

Marc Mitnick DPM

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fracture to 3rd metatarsal

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