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OPTIONS FOR NON-UNION 5TH METATARSAL FRACTURE?

Posted , 21 users are following.

naomi44083
naomi44083

Hoping someone has had a similar experience and might be able to give me some advice!

Over 4 months ago I broke my 5th metatarsal......I went to the local hospital, was told I needed to see the ortho surgeon, waited 5 hours, then sent home with a boot, no instruction and didn't see the ortho.  2 weeks later I had a follow up appointment at the ortho clinic at the hospital with follow up xray.....once again, ortho was busy, didn't look at my foot or xray and popped his head into the room to basically tell me i was ok and to see my own doctor in 4 weeks.  4 weeks later another x-ray, which seemed to show it was healing but had some way to go.  Another 6 weeks in the boot, then x-rayed again yesterday, and that x-ray showed it has now stopped healing and is non-union.

I'm very angry with the hospital as reading what I have above it seems I should have been told not to put weight on it for at least some time.  

This morning my doc is arranging an appointment with a surgeon but I will not let them do surgery as I've had many life threatening drug reactions in the past.  Are there going to be other options for me?

1 like, 55 replies

55 Replies

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  • naomi44083
    naomi44083

    Posted

    Sorry, another error in post above (why doesn't it let us edit?)....the device he suggested is called Exogen.

  • danielle94038
    danielle94038 naomi44083

    Posted

    I'm in Australia and in a similar situation although I don't have pain.  I broke my 5th metatarsal at the end of July 2016.  1 week in cast at the hospital followed by 7 weeks in a boot WB and then told it was healing well and to resume all normal activities with the exception of running which I could resume in another 4 weeks. 

    I did as I was told to do and resumed running after the 4 weeks and all seemed fine.  It was a little uncomfortable sometimes but never painful.

    4 months post break I went to the GP for something totally unrelated and he told me to get an xray so that he could have a record of where it was at with healing.

    After I had the xray done he called and said that it was a total non union and that it would probably never heal.  I'm a keen hiker and enjoy my fitness so this really distressed me expecially when he told me there are no further options.

    I asked for a referal to a Orthopedic surgeon and had an MRI and told me that he thinks it is healing really slowly and may take up to 18 months to heal. I am also on 3-18 months of no running, hiking or walking for exercise...so frustrating.

    I totally understand your anger with the hospital and your frustrations.  After reading a lot of other people's experiences I don't understand why I was WB with a boot from week 2.  I wonder if it would have healed quicker with 6-8 weeks NWB.

    I'm now 6 months post break and going to see if a podietrist can give me some advice.

    Good luck and I hope you can find an alternative to surgery and get healed and pain free soon.

    • tash49034
      tash49034 danielle94038

      Posted

      Hi Danielle,

      How is your foot going? Im also in australia with fx 5th metatarsal shaft. Im at 11 weeks post fracture. Clinical healing (im walking around fine) but fracture (non displaced) still present on xray. There's about 0.5mm gap between the pieces.

      My Dr thinks it is a fibrous union that jas developed. I have researched it a lot and found a few medical / radiography textbooks which say these usually eventually are replaced with bone. Am going to see specialist for consult soon and will see what they say.

    • Guest
      Guest tash49034

      Posted

      Did you end up getting a surgery on your foot, and how did it go?
    • fran92013
      fran92013 danielle94038

      Posted

      Hi Danielle 

      Please can I ask how you are now. I had a 5th metatarsal fracture 6 months ago. I was told to wear boot and weight bare as soon as I comfortably could. It is a non displaced fracture . Xrays are showing not healing. Like you I'm very active. I am a fitness instructor. I am only symptomatic at the point of the break. The rest of my foot seems ok. They have done a ct scan and am back at the hospital next week for result. Has your foot now healed.  Can you run again or did you need surgery? 

      Many thanks

      Fran 

  • kimmi555
    kimmi555 naomi44083

    Posted

    This is quite a bit later, so not sure if you are still looking at replies, but.. I am now in the same boat.

    Nov 2016 I fractured my 5th metatarsal, up by the toes. 6-7 weeks non-weight bearing, then 4 weeks in the boot. Just had an MRI and I have a fibrous non union. Podiatrist told me that it will never heal now. I can live with it as-is or have surgery.

    I have been using the Exogen bone stimulator, and have been in the boot 100% of the time. I have listened to all the rules and followed the common protocol and still ended up with a non union. 

    This weekend I will try to walk in a normal shoe for a little bit and see how it goes. I am an avid exerciser and love to walk, crossfit stuff, etc - I dont want to live the rest of my life worrying about this, so I may opt for the surgery. Not a great solution.. but there isnt really a great option for me. 

    • sandi27417
      sandi27417 kimmi555

      Posted

      Oh no Kim. So if you have surgery they will have to separate and rough up bone from what I understand. I have stated in the past that my orthopedic foot specialist recommends surgery for these fractures then 4 weeks NWB and 4 in bootI tried for 4 weeks before surgery to see what would happen and mine would have taken another 8 NWB. My surgery was painless and only took 45 min. Make sure the Podiatrits puts screws in lengthwise not crosswise. I tend to like Ortho docs over Pods but only because I live in a family of MDs . Good luck
    • tash49034
      tash49034 sandi27417

      Posted

      I am at week 11 spiral fracture 5th metatarsal. perfect alignment etcetc. was weight bearing pretty much since the start too (had to or i risked having to repeat a year of really stressful uni) no callus or bone healing apparently. foot is not really too sore to walk on, except maybe some plantar fasciitis. Dr today said probably fibrous non union and has given me referral for orthopaedic surgeon. what did you end up doing with your foot?

       

    • sandi27417
      sandi27417 tash49034

      Posted

      Where are you? For spiral in US surgery would have been recommended for that fracture. Please dongonto an ortho doc
    • tash49034
      tash49034 sandi27417

      Posted

      Australia. It's almost like a hairline fracture so was glad to avoid surgery if i could. Ive read in medical text books fibrous unions usually do ossify (replaced with bone), but will see what orthopaed says!

    • Guest
      Guest tash49034

      Posted

      Hi Tash, I have a spiral fracture at about 12 weeks and nonunion. The doctor said it is a fibrous connection. Did you end up going for surgery or just leave it alone?
    • Guest
      Guest tash49034

      Posted

      Tash, what did you end up doing for your fracture?

      I am about 5 months out from a spiral fracture of the 5th metatarsal. One doctor has said it is a fibrous union and I don't need surgery, the second has said it is a nonunion and I should get surgery. I am at my wits end trying to understand what will have a better long term outcome. I am curious as to  if you got surgery and was it a better result in the end?

    • cazza1956
      cazza1956 Guest

      Posted

      Hi how are you doing are you in a boot and PWB or not

      as am on bone stimulator to hopefully stop me having other op did my none union 

  • raisa94144
    raisa94144 naomi44083

    Posted

    hey how are you feeling right now? I'm facing the same situation like your right now!

  • sona53959
    sona53959 naomi44083

    Posted

    Hey Naomi, how are you feeling now I am in a similar situation please update your progress. 5th metatarsal fractures are really very frustrating. The whole world is celebrating new year and I am weeping over my fracture. I have a Mid shaft fracture in my 5th metatarsal. It's not displaced but there is a significant air gap in the fracture area. I was on cast for 3 weeks and boot for 4 weeks. Doctor said it's heeling well but. I Don't see any difference in my x-ray.

    • jvirgo
      jvirgo sona53959

      Posted

      Wow I see lots of people having problems with this type of break and totally understand how you feel. I myself am 8 months with boot still on with non union and never been offered any surgery! My leg looks like my thin arms and thenpain is terrible. I should have insisted I see a doctor from beginning rather than allow the nurses to treat me.  I'm hoping follow up next month will be decision time so I can get bank to normality. Feels like I've missed so much of my life already!! Any advice would be welcomed! 

    • Guest
      Guest jvirgo

      Posted

      HiJvirgo, I am wondering what you ended up doing. I am about 5 months out from a spiral fracture of the 5th metatarsal. One doctor has said it is a fibrous union and I don't need surgery, the second has said it is a nonunion and I should get surgery. I am at my wits end trying to understand what will have a better long term outcome.

    • jvirgo
      jvirgo Guest

      Posted

      I personally have had a really bad experience with all this. I'm now 9 months and still in air cast boot!!! (I can hear all the gasps!!) So my break only healed in Feb and I now begin the long physio treatment.  My leg too looks like my arms and muscle has virtually gone.  If it wasn't for the 50g of Amitriptyline and 600g of Gabapentin I would have probably ended up driving my auto car into a wall! I also have been treated by nurses throughout the 9 months (which I'm told is standard practice now) and an MRI scan 7 months later showed a load of tendon damage which is why I am still in excruciating pain. I've tried the heel to toe exercise on crutches without boot and can only manage 2 steps before I am in pain and can't make it back to settee! I leave the boot off as much as possible and only put on to walk around in. I still push through as much as possible doing the basic exercise but it's too much. Now I'm not sleeping again at night due to aching foot and cannot get comfortable. I should have made more of a fuss to push for a quicker recovery time but was told no surgery would help me and the break could take up to 18 months to heal! My life too has been on hold with no timescale of when I will walk again unaided as being in the boot all this time is unheard of! So please do push for x-rays and an MRI scan if you are still in pain and hopefully you will be on the road to recovery. I'm just spaced out most of the time so have allowed this treatment to happen to me and didn't really push again for any surgery to speed up this recovery time.  From the start, I was not told what I should be doing and not doing which has led to this length of time for the bone to heal. I hope my nightmare will prompt others also to ask questions and not be silenced with medication to cope with the truma of it all. Good luck and let me know how you get on. Also would like to hear from anyone else who have worn the air cast walker boot for 9 months!!!!

    • sandi27417
      sandi27417 jvirgo

      Posted

      This all sounds crazy!! Where do you live? I was 67 a year and a half ago when I had a non displaced stress fracture of my 5th. Waited 4 weeks NWB to see but it would have taken forever so had my foot specialist ortho doc pop a pin in. Then 4 weeks off, 4 in a boot then good to get back on my horse.  You have a much faster recovery with surgery with little chance of recurrence. Surgery was painless!! Good luck. You need another opinion for sure!!

    • cazza1956
      cazza1956 jvirgo

      Posted

      Aww that bad we’re are you from am 17 weeks post op

      And got none union bone and back in my boot With Crutches PWB but am on bone stimulator to hopefully avoid other op 

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