Hey Doc - Opinion on this x-ray?

[cashflyer]

(fracture is to the right, 5th metatarsal)


On 18 July, orthopedist put the patient in an "aircast", told patient to bear weight on it when possible, and that it would be "okay".


Do you concur?

I'm skeptical that the bone will mend in the proper position.
Patient works a "on your feet all day" type of job, was being considered for another job but will lose that offer if the foot is not healed properly to allow strenuous activity.

Patient has experienced continued bruising and swelling around the foot, and has a "second opinion" exam scheduled with a different orthopedist on Thursday.

[gatotom]

Well, myself being only a dumb chiropractor, its a nice clean break. I would think the ortho. knows what he is doing and probably wanting the aircast to gentally set that proximal metatarsal in place with that distal end.

Sure, this guy is going to be in pain for a few weeks anyway you look at it.

I guess the other option would be to pin the break together but that would involve surgery and more time off.

Anyway you look at a broken bone in your foot, you have just bought into a lifetime of a hurting foot.

I went to school just down the road from you in Spartenburg at SCSC.

[Rikao4]

well those 2 pointy ends moving about aren't helping..
he bears weight = they move=swelling/bruising...
sure he didn't mis-hear..
like stay off & and little or no weight for a bit..

not Dr...

Rika

[pavulon]

20 years ago, I had the same break on the same foot "wrestling" stocking foot in one of those sumo get-ups. I don't recall how displaced mine was or wasn't but I went two more rounds on it after it broke on the initial "charge" across the ring. Hurt like crazy for about a month but was in a (bigger) shoe (lots of swelling) and working 12 hours shifts on my feet in the ICU after two weeks. No surgery. Did I mention it hurt like crazy?

How old is the owner of that image?

[cashflyer]

Patient, my wife, is age 34.
I was in the room when he told her to bear weight when possible.

[pavulon]

Not an orthopod but I'd not hope for surgery and at her age, I'd think fracture mending has already begun. Light weight bearing may accelerate that process. An unbiased second opinion is a good thing...but if the second opinion recommends surgical correction, will you look for a third or ask if he/she owns a 991 that needs a new air filter or spark plugs?

Let us know what happens and good luck!

[craigster59]

Originally Posted by cashflyer

Patient, my wife, is age 34.
I was in the room when he told her to bear weight when possible.

Tried to kick you and hit the door frame instead?

[BeyGon]

Originally Posted by craigster59

Tried to kick you and hit the door frame instead?

Damn, did that with my brother, I was barefoot and broke my toe. I had to wear shoes all summer.

[Hydrocket]

For such a small bone, there's not much they can do. In an extreme case they might pin it. But it may be more trouble than it's worth. The ultimate alignment won't be perfect, but it shouldn't hinder you wife's life in any way after it's healed.

[bretski]

The fracture may heal just fine with limited weight bearing-and it may not. The fracture could turn into a mal-union or a non-union. Either case can be problematic but treatable. It is not inconceivable that a fracture like that could turn into a case of CRPS, and that can be ugly if not diagnosed promptly and treated quickly. I have seen CRPS in two patients with the very same fracture. In both cases the patients had a delay in the treatment of the fracture. You would have to go with the best ortho advice available. In the majority of cases the fracture heals just fine. Just be aware of possible treatment pitfalls.

[Jim Bremner]

I've broken my left wrist, green tree fractured my right fore arm, Popped the left elbow joint off, Broke my tailbone, Broke and displaced 4 ribs on the lower front left, Had a tendon pull a bone out of my right ankle, Crushed T 10 to half of it's height plus split a pie chunk of it out from 12o'clock to 3 o'clock, Whore house break on right heal, and blew the right side of the right heal off.



Please get a few opinions on her foot. My right foot hurts the most out of all of the damage that I've done. I'ts been 5 years now since the last 2 breaks ln the ankle plus my back. I still stand soft on that foot.

[cashflyer]

Thanks for the advice, everyone.
She's been reluctant for us to spend the money on a second opinion, as we do not have insurance.

My ankle received two fractures as a teenager, and I keep telling my wife that it is a lifelong pain that she really, really does not want. I now have some other opinions to hopefully keep her dedicated to getting this healed properly.

Originally Posted by KarriePoteete

I was in the room when he told her to bear weight when possible.
http://www.onfish*info/h.jpg
http://www.onfish*info/d.jpg

WTF is it with all the "onfish" spambots lately???
This is the third I've seen this week alone!

[Geary]

CF, I had that exact same break two years ago .. major separation because I dealt with the pain and kept skiing for a few days. It eventually healed fine, but joined together only with the help of an ultrasound stimulator. I still have the kit. If you want to borrow it for a few months, just PM me.

[Drdogface]

That's not much displacement at all and it should heal fine. When splinting or casting you must immobilize the joint above and below the fracture.... If there is a hard bottom surface to the air cast to walk on and the weight bearing goes from the bottom of the cast up to the leg at the top w/o bearing on the foot it will be fine...The purpose, of course, is to not allow motion at the fracture site...

Personally I would have used a fiberglass cast, split in half after setting, then taped the halves together...that allows it to be changed as needed...

Just my 2 cents...

[cashflyer]

Originally Posted by Drdogface

Personally I would have used a fiberglass cast, split in half after setting, then taped the halves together...that allows it to be changed as needed.

What... not carbon fiber? Seems like we could save some weight and improve acceleration if we use cf.

Thanks for the input!

[Drdogface]

Originally Posted by cashflyer

What... not carbon fiber? Seems like we could save some weight and improve acceleration if we use cf.

Thanks for the input!

No...dunno if they even make one like that. The FG cast material looks just the same as open weave gauze and you apply it after activation just like a gauze bandage or plaster cast. The FG ones are very light weight... I've used it dozens of times and love the stuff...the old plaster was a PIA compared to this..

This website will show a bit more info: http://www.tradekorea.com/product-detail/P00096161/Polyester___Fiberglass_orthopedic_casting_tape_Hyg ia_Cast_Plus_.html

[cashflyer]

Doc says her foot looks normal for this type injury, prescribed some different meds and said to quit worrying.

[DanielDudley]

Worry when you have to.