I think I have a Pseudo-Jones fracture...

[Meghan715]

I’ve been experiencing some pain on the outside of my right foot while walking for extended periods (ex. at the mall) Finally went to a podiatrist and he talked to me for over an hour about wearing better shoes, working out (definitely could loose a few, but not morbidly obese or anything), etc. He didn't think it would be anything severe but he would do x-rays anyway. X-rays 2 minutes before we left looked like the piece of my bone at the top end of the 5th metatarsel was broken, and not just broken, broken OFF. He said it looked to be an old fracutre and that I should (A) wear sneakers more than flipflops (B) If it doesn't help then to get orthopedic inserts. He never suggested a cast or a boot. I don't know if it because the break is too old to fix or what, but I would like a second opinion. ANY opinion would be nice.

He mentioned "marcher's break" quickly but said I should still just wear sneakers and hopefully the pain would go away and “anyone who tries to tell me I need surgery is young and stupid and wants to pay off his student loans”.... I think his intensions were good, but I walked away completely confused and unsatisfied - something I'm not accustomed to. The bone was broken off, completely. From what I've been reading that's not a Jones Fracture, but a Pseudo-Jones fracture. I'm a recent college grad w/out insurance, but willing to visit another podiatrist. What should/can I do? Assuming, like he said, it's old & broken off? I can get the x-rays if you'd like to see them. I’m in no way in a great amount of pain, it was just after visiting my mom where I did a LOT of walking when it started to bug me. It does hurt a little after I work out, but I'm only doing low impact (elliptical,) not the treadmill hoping to avoid the pain. When the pain is there, it's on the outside of the side of my right foot, as well as under the front of the foot. I don’t want to live my whole life avoiding putting too much stress on my foot… I can’t live like that.  Help :(

[Meghan715]

Thank you for your response!

Yes, the "break" is closer to the ankle than the toes. 3 Years ago my brother slammed a chair on that foot accidentally, but the chair leg landed more toward the front, about an inch behind the toes, more on the phanlanx(es)? - not towards the back of the ankle where this piece of bone looks to have "come off".

THIS IS NOT MY X-RAY:
http://www.cascadewellnessclinic.com/GRAPHICS/2ARTGFX/01ARTGFX/FT-X-RAY.JPG

That's the best example I can find to show you that's about the size of the area of bone that's broken off - and in that photo the bone is still connected where as mine is broken away.

http://www.aafp.org/afp//AFPprinter/990501ap/2516_f1.jpg
The red area in this photo, or a bit less actually, is what looks to have "broken off" mine.

While as ossicle is possible, and I definitely researched it a bit after your mention of it, it just looks likes a fracture to me based on the way the "fracture" lines, line up.

I'm guessing from researching this kind of break it seems like fixation surgery is my only option.

Right now not having health insurance - and having to wait until I do to get surgery. What should I do to lower/avoid the pain? Should be icing it? Should I be walking on it? Should I be working out? I'm somewhat heel-walking and walking on the inside of my foot, is this bad?

If I called the podiatrist I saw and got the x-ray would you have a look at it?

Thank you Doctor!

[Yena H Do, DPM]

is the break near the base of the metatarsal (which is closer to the ankle than the toes)?
have you ever had injury to the area in the past?  it may not be a fracture if there was no injury.  there is an ossicle that sometimes (for no reason) appear near the base of the 5th metatarsal.  it is called an os peroneum.  the peroneal tendons attach to the base of the 5th metatarsal.  everytime you walk, the muscle contracts and pulls at the metatarsal.  if there is an ossicle in the way, it wears down at the tendon and causes pain.  if there truly is a fracture and you continue to have pain, removal of the bone fragment helps tremendously. if the fragment that broke off is large, surgically repairing the fracture would reduce the pain. it is hard to recommend treatment b/c i haven't seen the xrays.  try wearing sneakers and see if it helps.  if it doesn't...i would get a second opinion.  old fractures that are separated do not heal with casting or w/ boots.  it has to be surgicaly put back together.