hello, Im in the Uk and I broke my 5th metatarsal (snapped the side bit off-avulsion) 2 weeks ago. I did it falling off the patio whilst pegging out the washing. I knew immediately I'd broken it. I am now in a foot plaster cast (non weight bearing) for 6 weeks. I was signed off work for 6 weeks. I've been feeling extremely tired and not myself. Is this normal? Did anyone else feel like this?
Does anyone know what happens after the cast comes off? Please let me know your experiences. I have noted there appears to be a difference in how Uk and u.s treat such an injury
When comparing the treatment of base of the 5th metatarsal fractures, you have to be careful in that you are comparing the same injury. Not all avulsion fractures are the same. They are also sometimes called Dancer's or Jones' fractures (after Sir Robert Jones - who injured his foot dancing around the May pole).
Thus treatment depends upon the exact location of the fracture line, how much of the base was pulled off, and whether or not the joint is involved. So, even though they may all be called avulsion fractures, some can be treated in a cast (immobilization), while others require surgery to get the best result (internal fixation).
But, you are correct, in that in the US, patients are less willing to deal with immobilization even to the point of risking surgery (when a cast would probably do just fine). Also, there is private insurance in the US, so patients often don't realize how expensive surgery actually is.
So, in your case, sometimes after the 6 weeks of nonweight bearing, the orthopedist will go to a walking cast for a few weeks. This is just to get back to putting weight on it, while still having it stabilized for comfort (occasionally they will use a walking boot, instead of a cast, so you can take it off and work on range of motion). However, other surgeons will go straight to full weight bearing right out of the cast. (Of course, this all depends upon how the bone is healing.)
When you come out of the cast, the hair on your leg will be really long and the skin very soft and tender. So, don't scratch during your first shower. The sole of the foot will be hypersensative and there may be a build up of dead skin that has not been able to be shed. The calf muscles will be small, as they have atrophied while being in the cast, nonweight bearing. The ankle joint will be very stiff. So, don't buy tickets to the dance for the day your cast comes off!
Thank you very much for your advice. I went back to the hospital today and the fracture has only healed slightly. He said it is one of the slowest healing fractures. He has taken the plaster cast off and I have been told not to weight bear for another 6 weeks. Just walk on my heel with crutches. He also signed me off sick for another 6 weeks, which I'm really shocked about. It's a long process !
Just had my cast removed after a 5th metatarsal avulsion fracture - I had a removable walking cast - its only healed about 80% of the way - have to go back to hospital in another 4 weeks - told to walk on foot but still very painful and uncomfortable. I am hoping it heals over the next 4 weeks other wise it may be a scan and surgery. I too have been feeling very tired and not myself but think its probably because I am not used to sitting around so much and not being able to work. I am working from home but its not the same. Hope You are fully recovered by now.