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Fifth Metatarsal Avulsion Fracture

Discussion in 'Ask your questions here' started by Unregistered, Sep 28, 2009.

  1. Unregistered

    Unregistered Guest


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    Greetings and thank you in advance for your generosity in addressing my question. I am ten weeks into a 5th metatarsal avulsion fracture sustained by turning my ankle. Was non-weight bearing for 6 weeks in a boot, followed by 3 weeks in a fiberglass cast, which was put on because though the xray indicated healing, I was in so much pain that I couldn't bear weight. The cast helped a lot with the pain. Now, I'm back in the boot and though healing has continued I am again in excruciating pain. At night it feels as if I am stepping into hot lava. During the day as I weight bear it feels as if the entire bottom of my foot is bruised and blistered. My questions: Is it normal for a foot that the xrays say is healing and my doctor believes is almost totally healed to generate pain to levels 8 and 9 after ten weeks? What might be best for me to consider to lower the pain level? The 3 norco 10/325's and 1500 mg of neurontin I take daily don't improve the pain much, though ice and elevation help a bit. I don't want to take more pain meds if I can help it. Are there any alternative healing methods that might be useful? Infrared? Photonic stimulator? Or? Does anything in my description lead you to believe that my doctor may have missed something? I'm a bit desperate and would deeply appreciate any insight you might have to offer. Thanks, Maria
     
  2. FootDoc

    FootDoc New Member

    DISCLAIMER:
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    It sound to me that either you had far more than just a typical avulsion fracture of the tuberosity of the base of the 5th metatarsal or their are some dramatic complications. I have treated many such fractures without casting and most were continued on weight-bearing throughout the healing process which in most cases was uneventful, although partial fibrous healing is not uncommon. In my experience, your complaints are not typical for the type of injury which you seemed to describe. But, as I always point out, most traumatic injuries are multifaceted, and there is often more to them then you or even your doctor may be aware. I would recommend that you make your complaints clear to your doctor and insist on getting real answers.
     
  3. Unregistered

    Unregistered Guest

    Thank you for providing a reality check and for your encouragment to talk to my doctor. I will approach him with a more robust request for further investigation of my injury. (Might I trouble you to explain what you mean by fibrous healing?). Thanks, again, Maria
     
  4. FootDoc

    FootDoc New Member

    The peroneus brevis tendon inserts into the styloid process of the tuberosity of the 5th metatarsal base. An avulsion fracture occurs when a tendon or ligament pulls and avulses a portion of bone. This results in some amount of separation between the main section of the bone and the avulsed sement. In the case of the avulsion fracture which I have discussed, the tendon continues to pull, often causing a distraction and a gap between the bone segments and it is difficult to completely stabilize this and enable bone to bone contact without surgery. The need for surgery is often determined by the size of the avulsion and whether or not their is plantar or doral displacement or rotation of the avulsed segment. The distraction often results in the interposing of a fibrous non or incompletely ossified band between the fracture segments and often this can be permanently seen on x-ray, appearing, but not actually as a gap in the healing. It is generally a healing which is stable and functional and one which is generally not a cause for concern.
     
    Last edited: Sep 29, 2009
  5. neenstie

    neenstie New Member

    I an currently in a cast after an avulsion fracture. The symptoms you are describing are exactly what I had before I had my surgery. The ER put me in a horrible boot (foot slipped all around inside) until I could see the surgeon. At night, I had my foot elevated while I slept but the burning sensation would wake me up from a dead sleep!! The piece of bone which was broken off and flipped backwards must have been aggravating a nerve, I can only assume because my dr and I didnt really get into that discussion. The surgeon put in two screws to attach the piece back on and I have not had burning one time since the surgery, about 3 weeks ago.

    I was able to stop taking pain meds three days after the surgery. I would be more aggressive in getting answers and, if that does not work, find another dr. You've been suffering too long, in my opinion.
     
  6. Red Boots

    Red Boots New Member

    Could you also have a Jones Fracture? I have been checking internet sites for info after visiting the doc today for an avulsion fracture that is not displaced. I am in a boot for two weeks with no weight bearing, and then in boot with weight bearing as tolerated after that for a total of six weeks depending on healing. I was reading about a case similar to yours in which pain continued after apparent healing of the avulsion, and it was discovered that there was also a Jones fracture that did not show on the first xrays. A Jones fracture takes a long time to heal because the blood supply is not very good in that area. Just a thought ; you might want to check it out. Good luck!
     
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