Orthopods: 4th metatarsal fx

[s4yxia]

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I just had a quick question on how to manage 4th metatarsal fx to all orthopods out there. A pt came in after landing incorrectly on his left foot from one of his jumps at Airborne school and X-ray revealed that he has a slightly displaced intra-articular fracture of the base of his 4th metatarsal. Although surgery was deemed not necessary at this time, he was put in a Camwalker and placed on crutches and was told not to weight bear for 3 weeks by his Podiatrist. I was wondering if the Orthopedic surgeon would do something different and maybe having him weight bearing sooner to help with the bone formation? Also, what are the likely long term complications from this injury? Finally, are there any physical activity/exercise that he may participate to help the healing process? Thank you very much from a 4th year med student.

 

[Kalel]

Sounds like a "march fracture". I'm not an orthopod, but I do remember that surgery is usually not indicated in stress fractures of the metatarsals and that rest and giving the fracture time to heel is standard therapy. Anyways, I did a search over the internet and was able to find this website:
http://www.aafp.org/afp/20031015/1527.html
The only thing that I would reccomend for your friend besides what the podiatrist did is taking calcium supplements.

 

[ortho2003]

No need for calcium or anything. He should do just fine. If he is in a cam walker, he probably could weight bear as tolerated once the initial pain resolves.