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Foot trauma from dropped weight

by Bethany
(Knoxville, TN)

crush injury

crush injury

Two days ago, I dropped a 15 pound weight on my right foot.The pain was excruciating and I felt it the most shooting up my pinky toe. It turned black and blue instantly, and the swelling got pretty bad. I was sure I broke it because I've never had a broken bone in my whole 35 years of my life, and I've dropped heavy things on my foot before, but I've never had this much pain, bruising, and swelling happen before. I went to the ER about an hour later. They took x-rays and the doctor came back and told me that I hurt it pretty bad, but it wasn't broken. I bruised a bone, had a contusion, and a hematoma. Which sounds to me like a fancy word that doctors use instead of a bad bruise. I've had 3 kids and 2 back surgeries, and my foot hurts worse than all of that! A bruise wouldn't feel this painful. Day 2 and the bruising and swelling is worse, and now I have a very painful lump that is about the size of a pea that just appeared out of nowhere about an inch below my pinky toe which is where the weight directly made impact. I did some research and found that sometimes a broken metatarsal doesn't appear on an X-ray for a couple of weeks later. My question is this...do you think that it may in fact be broken? They wrapped my foot up in a right bandage,stuck it in a wooden boot, and they gave me crutches that I have to use for 4 weeks. The pressure from the bandage and the shoe is causing my foot to hurt alot worse, so I admit that I have had it off more than I have had it on. And I've never used crutches before, so I tripped a few times which caused me to land directly on my foot flat on the ground, which is when it started hurting worse, which is how I noticed the lump. Do you think that it may have had a hairline fracture already and when I tripped and landed on it, it snapped the bone the rest of the way? I wasn't wearing the bandage or the shoe when I tripped on the crutches and landed on my foot, and all of my weight was on my hurt foot when the pain, bruising, and swelling got worse and that's when the lump appeared too. So I'm worried that by not wearing the shoe or the crutches all the time has caused more damage. Should I call my primary care doctor in the morning and get in to see him before the weekend gets here, or wait over the weekend to see if it gets any worse? I attached a photo, but you can't see anything very clearly. I made an arrow that points to where the lump is. Thank you for your quick response!


RESPONSE

Hi Bethany,

At the very least this problem is beyond the scope of your primary care doctor. Your better move would be to see a podiatrist or an orthopedist as they are better equipped to handle any issues that may have developed.
There is certainly the possibility that you did further damage when you tripped. The only way to know for sure would be to have another x-ray.
Assuming, for the moment, that you did not do any further damage,then based on your first x-ray, even if you did fracture the bone, but it did not show up on x-ray, we would call it a non-displaced fracture meaning with immobilization it should heal.
The other problem I see from your narrative is that apparently the dressing that was applied was too tight.
Typically after trauma to the foot, the foot will swell which is normal. So a dressing applied initially which might be snug, will become too tight once the swelling begins.
Since you did trip, I would certainly recommend another x-ray. If there is no further damage or even if a fracture is present but it is non-displaced meaning there is just a crack in the bone, then immobilization and non-weightbearing would be the treatment of choice.
I should also point out that in the type of injury you suffered, dropping a fifteen pound weight on your foot, if there indeed was a fracture it would probably have been a crush injury to the foot meaning if there was a fracture it would show up as a crushed bone rather than just a crack in the bone. My point being, that type of fracture most certainly would have shown up on initial x-ray.

Marc Mitnick DPM
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