5th Metatarsal Break - Displaced

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I broke my 5th metatarsal 8 weeks ago tomorrow. I live in the UK. I am almost 7 months pregnant now as I am typing this. When I went into A&E initially I was advised that my break was aligned and it would take 4-6 weeks to heal. I went on in crutches as I was unable to apply any pressure but was advised to walk on it as soon as I could in an aircast walking boot. They would have had me walking on it out of the hospital had I not been pregnant and brought my own crutches.

Just under 2 weeks later I had my first appointment at the fracture clinic. I was still in extreme pain. Being pregnant I couldn't take anything other than paracetomol and still had extreme swelling. My consultant advised that due to me being pregnant he wouldn't re x-ray me and to come back in 6 weeks time. He also advised me at this point that I should be walking on it and walking on it would make no difference to the healing process. I mentioned at this point the air cast walking boot was giving me some problems in pain and he advised to wear a supportive trainer or even an ugg boot!! This seemed utterly ridiculous and he didn't give me any more advise so I ended up sticking to the air cast. He also mentioned how I had an 80% chance of healing, reducing to 50% if I smoked which I don't.

At 5 weeks I managed to slowly begin to walk on my foot after weeks of only putting extremly light pressure or nothing at all due to the swelling still being immense. By week 7, 22nd April, I was able to use it and not really experience much discomfort of the foot. There are still days when I'm in pain and it does swell but I put that down more to the boot than the foot itself.

25th April, I had my follow up appointment. My consultant had me in and out within about 5 minutes. He looked at my foot, pressed hard, noticed I was still in a small amount of pain but nothing major and informed me he wouldn't re x-ray me due to me being pregnant, he could tell it wasn't broken, he wouldn't inform as to what the type of break it was even though I asked multiple times, and that I should return in 3 months time after the baby has been born as I am likely to need a CT scan and surgery. He also advised at this point that the bone was displaced, which I had never been advised upon previously at all!! I was actually informed it was all still aligned. So every appointment I have gone to I have been informed of more and more negative information making my condition worse, and from what I can gather from my own research, I shouldn't have been weight bearing at all for quite a few weeks and should have had surgery if the bone is displaced and it's now going to be harded to fix. I heard him mention on his dictaphone as I left that I had broken it at the base although he still refuses to clarify which is ridiculous! Surely I am entitled to know my own injury!?

I am now in the process of looking to speak to someone privately which is going to cost a fortune and have found out I'm not on my husbands private healthcare as we initially believed. I would much rather have surgery now,  weeks before the baby is due so I can recover than have a newborn and toddler to run around after and then have surgery. 

Can I be operated on if I am pregnant? I believe I can have an epidural type surgery that numbs everything whilst being awake? Are there any negatives to this? Is it likely that this will heal without surgery? Unfortunately I have been unable to get hold of my consultants secretary to get hold of the notes to go private as of yet which is extremly frustrating. I just don't know where I stand. And I'm assuming that it's going to be harder to fix now we are 8 weeks down the line already!?

Any advice or experience is much appreciated.

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  • Posted

    Hi I'm not sure they would be too keen to operate with epidural while you are pregnant, its OK if its needed to delivery because baby would be being delivered, your consultant is correct, daft as it may seem walking actually aids the healing, I have fractured hip and pelvis and I'm told I can weight bear to tolerance to help heeling and because bones like yours are so small then being displaced want cause a problem once healed.

    Don't be too keen to go under the knife if you can do without

    Happy parent hood

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  • Posted

    Gosh I'm so sorry that this has happened to you.  It sounds very frustrating and you certainly don't need that at this time.  I agree with Alexandria that you should want to avoid surgery if possible.  I also broke my 5th metatarsal.  I don't know where the "base" is.  My break was called a Jones fracture and was far back from my toes.  It was not displaced and I was in a short air boot without pain for the 1st week before I saw the orthopedist.  I thought he would tell me how well I was doing and that I could take the boot off to drive because I was walking to the bathroom in the middle of the night without pain.  I had also been doing the RICE procedure.  NO, he scared me telling me all the things that could go wrong resulting in surgery/pins/screws etc and put me in a non weight bearing cast from my toes to my knee for 4 weeks.  I cried!  The knee scooter was kind of fun but it doesn't do stairs and I was afraid of crutches.  I thought I'd fall and break my other foot.  For my Jones fracture and at my age (69) he did not want me weight bearing at all for fear of displacement.  After 4 weeks I was to go into a weight bearing cast but since I was doing very well I talked him into a knee high air boot. and walker.  He made me wear the boot day and night too because he didn't want we walking to the bathroom at night without that support.   At first that boot HURT especially at night when I tried to sleep and I wanted my cast back!  I was strapping it on too tight I guess and I started making it looser and would leave off the plastic front piece.  That worked for me.  Over those 4 weeks I gradually transitioned by using the walker to full weight bearing in the boot   After 8 weeks total I was good and was released to physical therapy without any support.  I did favor that foot and had a slight limp.  I think that was just getting used to walking without the boot which made both legs the same length so I didn't have to rock from side to side.  I certainly do not know how your doctor could press on your foot and say oh, now the bone is displaced.  I think that would take an xray and that you would be in more pain if the bone was displaced  I don't think that displaced bones always result in surgery but probably a NWB cast first.  I remember thinking that with all the things that could go wrong and cause more time and pain only to end up with surgery that I wanted it right away too.  I didn't want to wait but I've very glad that I did because all went well and I hope that all goes just as well for you. Take care and remember RICE heals too.

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  • Posted

    So just as an update, I have managed to get another appointment booked in for this Tuesday coming to ask alot more questions. I'm hoping to push for an x-ray. His answer so far to no x-ray has been due to me being pregnant and outweighing the risks but due to a complicated first labour, I could be in a position that if my foot isn't healed, and it's not possible to deliver baby in the boot, that I may be opted for a c-section which obviously wants to be avoided at all costs if possible.

    I still don't understand how he can just feel my foot and say it is not healed when there is no pain to the area on touch? The only time my foot hurts now is if I am walking on it all day it aches, but think this is a combination of not much use for those first 5 weeks, being 8 months pregnant now and carrying extra weight and running around after a toddler. It aches when not in the boot and if it's leant at a weird angle but could this just be down to again not being held in that position for such a long time? And there is never any swelling to my foot anymore and the only other time it hurts is if I sit in a boiling hot bath for about an hour or more.

    I'm praying all these things mean that it's healed/healing? Does anyone have any experience or advise at all? If I'm no longer in pain with it when walking or to touch does that mean it's likely to have healed? Completely off all paracetomol that I was taking consistently aswell. 

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