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

four broken metatarsals

I broke four metatarsals in my foot 8 months ago and had a Jones fracture. I was in a cast for 12 weeks, and a screw was put in to hold the bones together. The doctor told me I was completely healed two months ago. However, my foot is still sore and swells and I don't have complete mobility. He told me I had 10% disability which he reported to the insurance company before releasing me. I was on Workman's Compensation. I would like to know if it would help my mobility and reduce the swelling if I had the screw removed or, if not, would it help my foot to have more physical therapy?


RESPONSE

Hi,
If you broke four metatarsal bones it would not surprise me that you still have residual pain eight months later. The problem with feet unlike a hand, for example, is that you have to walk on the foot and everyday walking will delay the healing in your foot.
I do not know how bad the original fractures were and I would assume the screw was placed in the site of the Jones fracture, but the more complicated the original fractures, the longer it will take for resolution of pain.
The type of work that you do will also play a role in the timely healing process. If you are on your feet all day at work and work on very hard floors or carry heavy material, that too, will
lead to a delay in healing.
Physical therapy could be very helpful in moving the process along. I would try at least one month worth of therapy and then decind if it is helping. If so, I would then continue with it; if not I would cease the therapy.
Removing the screw is an option, but it is an option somewhere down the road as the purpose of the screw in a Jones fracture is to keep the fracture closed in an area that typically has a very poor blood supply which in turn can delay or even prevent a fracture from healing.
As a general rule, the screw should stay in for at least a year and then it would at the discretion of your surgeon as to when the screw should be removed.
Keep in mind, the screw would only be removed if the lions share of your pain was in the area where the screw had been inserted.
You are at the eight month period and in most people they would be well on their way to having this problem resolved.
If the foot bothers you enough, you might ask your doctor about an MRI which would give a better visualization of what is going on in your foot, if anything, compared to an x-ray. Sometimes bones may look clinically healed on an x-ray, but there may still be issues and an MRI should be able to identify any residual problems.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

DISCLAIMER: The purpose of this site is purely informational in nature. It is not intended to diagnose, treat or cure any medical condition. This information is not a substitute for advice from a medical professional. Please consult your healthcare provider for accurate diagnosis and treatment. The information presented here may be subject to errors and omissions.


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(location unknown)
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(location unknown)
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Unknown location

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New Zealand

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Poland
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South Carolina
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Arlington, VA


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San Clemente, CA


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location unknown


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location unknown


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Bre

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anonymous



Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous



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Poland



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Seattle, WA


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location unknown



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New Jersey



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Debbie

location unknown



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Evansville, IA



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San Diego, CA



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Albany, NY



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location unknown



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Whichita, KS



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Boston, MA



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Colorado



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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
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Canada
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location unknown
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Wisconsin
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location unknown
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North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

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Bessie Mae

Florida
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Lynne T.

location unknown
Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey


Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown


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Lenoir, NC


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Bellevue, WA


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Jodi

location unknown

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