General Discussion Triathlon Talk » 5th Metatarsal Avulsion Fracture Rss Feed  
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2011-07-15 4:54 PM

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Subject: 5th Metatarsal Avulsion Fracture
Three weeks ago I was out for a quick "shake out" run before making the long drive to Coeur d' Alene to compete in my 4th Ironman. Car was packed, bike was loaded and ready to go. During a very routine run I stepped on a rock, rolled my left foot and broke my 5th metatarsal. Just like that, 8 months of hard work down the drain. I was devastated...still am. Confirmed at the ER and again at the Ortho as an Avulsion fracture (not Jones). The fracture is "minimally displaced" and another foot surgeon called it "VERY minimally displaced". I've been in a boot/cast and using crutches for three weeks now. Swelling subsided about a week ago. Foot looks better. Pain is decreasing ever so slowly. I use crutches when going long distances (to the parking lot, at the store, etc). The Ortho has taken the ultra-conservative approach with me (I feel). Telling me 8-10 weeks in the boot/cast, start swimming around 3-4 weeks, stationary bike around 6 weeks, no road bike until 8 weeks and then a full 12 weeks to run again. Last week I swam for the first time 1,500 yards, pull buoy the whole time, no pushing off with bad foot, was super careful. Immediately after swimming there was pain near the fracture and that pain kind of worsened as the day went on. Anyway, I thought I'd post all of this in case there are others out there who have had this injury and can offer their experience or advice.

http://home.comcast.net/~jmoss70/FootLat.jpg



2011-07-15 7:10 PM
in reply to: #3598891

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Subject: RE: 5th Metatarsal Avulsion Fracture
I am so sorry that happened.
I was in a boot for an calcaneous stress fracture last summer, I got the boot off after a month and a day later I broke my little toe and the one next to it. Very bad luck! My podiatrist wasn't too concerned. I taped them to the next toe for a couple of weeks and wore wide toe shoes. I was very thankful he didnt put me back in the boot. There was a lot of bruising and swelling the first week then it went away. My podiatrist told me I could resume activities conservatively once I had no pain. I was able to bike and swim after a week or so, I used a bouy to remind me not to push off the wall, and I loosened my bike shoes. I hadn't really been training hard due to the stress fracture, so I started out with a walk-run program about 3 weeks after breaking the toes. I am guessing that your doc is being more conservative because your break is probably worse than mine. I just used pain as my guide, when I could touch and move the toes without any discomfort then I felt I was ready to run again. Maybe your doc will OK you to bike and swim if you are healing well?
Again, I am so sorry for that bad luck. Wishing you a speedy recovery!  
2011-07-23 10:58 AM
in reply to: #3598891


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Subject: RE: 5th Metatarsal Avulsion Fracture

This is a bit of a touchy injury. The tendon actually pulls the bone hard enough to cause it to fracture.

The ortho's plan is correct in this case. You want to avoid any further pulling on the bone. Ice it down after each swim and let pain be your guide. 

I see this one a lot in my clinic and healing time is your best friend. You can always build the muscle back later, but it take a surgery to re-attach the bone if you pull it all the way off.

Easy does it. Good luck with the rehab and think about the long term.

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