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
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 DPMDISCLAIMER