5th Metatarsal Fracture
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A 5th Metatarsal Fracture is unlikely to heal without a cast or walker boot as the impact and vibration from walking can irritate the fracture site, preventing it from healing. More recently all patients with a foot fracture are placed in an air cast walker boot rather than a cast so that they are more mobile. Air is pumped around the boot to act as an extra cushion for the foot and weight-bearing facilitates for healing of the bone.
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It is normally advised to wear a boot for 4-6 weeks, when if pain-free you can wean out of the boot indoors between weeks 4 to 6. For those with low vitamin D levels, osteopenia or osteoporosis may be required to stay in the boot for the full 6 weeks or sometimes longer if it is still not pain-free at that stage.
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The following factors should be considered to all a 5th metatarsal fracture heal as quickly as possible:
If you are walking in a boot with a fractured 5th metatarsal you can walk as long as there is little to no pain. Walker boots are to facilitate walking short distances and should not be used for exercise. Once your period of time in the boot has ended, it is recommended to wean out of the boot and to wear cushioned stability trainers when walking.
Gradually increase your walking distance by 5-10 minutes daily if there is no pain when doing so.
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You can return to running approximately 2 weeks after taking off your walker boot. In the earliest cases, athletes return to run 6 weeks after their injury.
It is recommended to begin with pain-free walking followed by a hopping protocol before returning to run after a 5th metatarsal injury to reduce the risk of recurrence.
Running could commence on a treadmill initially as it has some cushioning and then progress to flat smooth surfaces outdoors.
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If you are wearing a walker boot and relatively resting from activity but your pain is getting worse you should return to the Fracture Clinic. These injuries normally heal without any issues but in some circumstances, this does not occur and an operation if required.
Surgery is often in the form of fixation or bone graft. A period of immobilization is normally required followed by 6-8 weeks of Physical Therapy.
This is not medical advice and we recommend a consultation with a medical professional such as James McCormack to achieve a diagnosis. He offers Online Physiotherapy Appointments for £45.
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