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The response to the question below was authored by Marc Mitnick DPM
Delayed diagnosis of matatarsal stress fracture
I broke my middle toe a year ago, and because of continued soreness and occasional swelling they took another x-ray that showed a partly healed metatarsal stress fracture that was missed before. They are considering having me wear an Aircast for 6-8 weeks to see if it can heal better. Is that possible after walking on it for a year? Also, can a metatarsal stress fracture effect the way a toe moves and would it effect the toes on either side of the toe it's connected to? Or are these issues more likely due to the broken toe that has already healed...like an arthritic side effect after healing?
Thanks for any light you can shed on these kinds of issues. I have x-rays on CD, but don't know how to send them...anyway, the stress fracture can't been seen easily without blowing it up to 400% and then zooming in with a magnifying tool. It runs the center third lenghtwise of the middle metatarsal.
A few things worth mentioning. I doubt a stress fracture of the metatarsal would in any way affect the pain in your toe, unless the fracture was severely displaced in which case you would have had a lot of pain in the area of the stress fracture. That leads to my next point. If the stress fracture does not hurt you can probably leave it alone. Many times when we surgically break a bone, down the road we will take an x-ray and although there still may be a "crack" in the bone, if there is no pain, we discharge the patient.
Lastly, at this point I do not think immobilization will heal the fracture. If you are interested in healing the fracture you would have to try a bone stimulator.
Marc Mitnick DPM
Johns Hopkins Medicine
University of Rochester Medical Center
American Academy of Pediatrics
Penn State Medical Center
National Institutes of Health
Columbia University Department of Rehabilitation
Stanford Health Care
Illinois Bone and Joint Institute
Mount Sinai Hospital
Institute for Chronic Pain
University of Florida Health
American Family Physician
University of Maryland Medical Center