Displacement?

[GoldenBC]

I read in another answer that "displaced fractures of over 2-3 mm should usually undergo surgical correction."  I had a 4 mm displaced fracture of the base of the 5th met (non Jones), which at 6 weeks had only slight healing, and at 8 weeks no further healing.  I'm waiting to get into an ortho to see what's what now.

An ortho was consulted when I initially broke it, but the concern seemed to be that it went close to (but not into) the joint space as far as a pin.  Should it have been pinned initially?  Is the 4 mm displacement contributing to the lack of healing?


This discussion is related to fractured foot lots of questions.

[GoldenBC]

Well, according to the orthopedic surgeon, he says the break is healed.  However, I asked about the excruciating pain at the cuboid bone and he seemed perplexed by that.... In info I've looked at online, I am wondering if it is POPS (Painful OS Peroneum Syndrome) as it's exactly where the diagrams show that to be and I know I have an OS Peroneum, and went sideways in my shoes when I went over on my ankle (so shoes crossed my foot there).... He's not the type of ortho that I could ask about something I've read on the internet (old school).  He said there is inflammation there, prescribed orthotics to relieve pressure on that side of my foot ... I agree there is inflammation, but it feels like a rock in in my foot  so we'll see... I'm to see him in 6 weeks (after 4 weeks of wearing the orthotics) so hope I'm not wasting 6 weeks...

[GoldenBC]

Thank you!  I am seeing the ortho on Feb 1 to see what's what with the 5th met, and it also appears that I may have tears in my peroneal tendon(s) where the cuboid bone is, so shall be seeing about that too.

[Dr Vinod]

Hello!

The decision of conservative treatment is taken by an Orthopedician after taking into consideration your age and the amount of physical activity you are involved. Treatment is by below knee walking plaster cast for 3 weeks for Jones and 4 weeks for other kinds of non displaced fractures of your metatarsals. For displaced fractures you may need manipulation and immobilisation in plaster cast.

As you have passed 8 weeks with no further healing you can explore options for surgical repair.
Open reduction and internal fixation with k-wires may be required.

Discuss all pros and cons with an orthopaedic surgeon. Take second opinion.

Take care!