I just had surgery for a broken fifth metatarsal bone. They drilled a hole down the middle of the bone and put a long screw through there to hold it all together. How long should I expect to wait before I'll be back on my feet again?
Fractures of the fifth metatarsal bone can be very complex and a challenge to treat. They don't always heal well. If the ends of the bone pull apart, getting them back together and keeping them there while healing takes place isn't always a straightforward and easy task.
Postoperative recovery can take quite awhile (weeks to months). Treatment may occur in a series of steps. First, a weight bearing cast boot is placed on the ankle and foot. The patient wears it for the first two to three weeks. Once pain has been controlled, then a motion-controlled athletic shoe is worn for another three to six weeks.
A physical therapist sees the patient early on to begin rehab. The goal is to return the patient to his or her previous level of activity as soon as possible. For the athlete, this would be a return to sports participation at a level equal to (or better than) before the fracture.
But there are still many unknowns about treating fifth metatarsal fractures. Future studies are needed to identify which patients need surgery and when (how soon). Results may vary with different types of fixation devices.
Research to show which implants to use with each fracture type would be helpful. And finally, studies are needed to develop evidence-based guidelines on when it's safe to resume normal activities -- or for the athlete, when returning to sports is possible.
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.
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