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

Fracture 5th metatarsal

by Michele
(Perth. Australia)

Hi, I somehow missed 2 high steps and had a "flying"fall. The ED department said I had a pseudo jones fracture. My foot had been very swollen and bruised ( mid foot also) with swelling abating during the last week. Instructed by hospital to non weight bearing for 4 weeks in a air cast boot. Still painful in both sides of upper ankle and swollen midfoot below toes. After just seeing Orthopedic Dr who lightly examined my foot by pressing lightly on one side like checking for a pulse was told to begin weight bearing with no boot in two weeks.He said fracture had healed. During traveling home after mild exam I suffered very severe pain which even after strong pain relief was present until the next day. I had tried to weight bear in boot yesterday and this morning my foot is swollen and painful again. I am not sure what to do. I don't want to not do what I am told, but at the same time I don't want to do anything which will make it worse. I am a 57 year woman. Your advice would be appreciated.

RESPONSE

Hi Michele,

My first piece of advice to you is to find another doctor. After four weeks with a fifth metatarsal base fracture there is no way this doctor can tell if it is healed without an x-ray. Since you do not mention an x-ray, I will assume none was taken.

Any doctor worth his salt knows that fractures at the base of the fifth metatarsal bone have a high incidence of non-union (not healing), so to tell you to start bearing weight without even looking at an x-ray is inexcusable.

However, you state that he told you to bear weight in two weeks. Did you bear weight right after your visit? I do not know why your foot would start to hurt otherwise. I doubt it would start to hurt simply because he touched your foot.

In any event, if the foot is continuing to hurt and you have not been putting weight on it, then you need another x-ray and examination to see what is going on with the broken bone.

On a side note, and I will preface this by saying, I do not have the luxury of actually examining you so I have no idea what is going on, there is also the possibility of a phlebitis in that area of the foot particularly if it is swollen to a fair degree. I mention that possibility simply because I do not know how the foot could start to hurt so much, particularly if you did not walk on it.

So, my advice to you is to see a doctor, preferably someone other then the last one you saw.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

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Arthritis Foundation

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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

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Fracture 5th metatarsal

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