Houston Methodist. Leading Medicine

Foot FAQ

Question:

One of the girls on my volleyball team has a broken foot that won't heal. It's the long bone to the fifth (baby) toe. I thought growing teenagers healed fast. What could be holding up her progress?

Answer:

You might not realize it, but a fracture of the long bone in the foot to the little toe can be a very serious injury. It's called a fifth metatarsal fracture and it's most often seen in athletes. What makes this such a problematic injury? Disruption to any part of the anatomy such as the bones, ligaments, joint capsule, blood supply to the area, and nerves controlling sensation can lead to poor recovery. In fact, the risk of nonunion and even refracture after successful union is a reality for many athletes. Wherever the fracture occurs, the patient usually has pain, swelling, and can't put weight on that foot. The type and severity of the break can make a difference. Treatment of some kind is needed. Usually, the individual can't keep walking on it and expect it to heal. The more displaced or separated the broken parts are, the greater likelihood that surgery will be needed to repair the damage. If the broken ends of the base fracture are less than two millimeters apart, then the patient can use a cast boot, walking cast, or even a hard-sole shoe to protect the bone while it heals. Patients should expect about a six weeks period of time before healing is complete. This can take longer if there has been any damage to the ligaments, blood vessels, or nerves. More severe fractures or fractures that don't heal with conservative (nonoperative) care require surgery. An incision is made directly over the bone. The surgeon is careful to avoid the nerves in that area while aligning the bone and holding it together with screws. This procedure is called an open reduction and fixation. If your player has not had an orthopedic evaluation, a visit to the orthopedic surgeon is needed. If she is being treated by a surgeon but without the expected results, then it's probably time for a follow-up visit. The earlier problems are recognized, the better her chances are for getting proper treatment and an improved outcome. Mark M. Casillas, MD, and Nicholas F. Ortiz. Fifth Metatarsal Fractures. In Current Orthopedic Practice. March/April 2009. Vol. 20. No. 2. Pp. 140-145.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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