Question
I recently fell at 29 weeks pregnant (4.5 weeks ago).  I was told i had midfoot sprains to both feet intially but because of pain i could not walk so we rented a wheelchair.  After two weeks i pursued an MRI since the pain continued.  The pain showed a transverse fracture of the medial cuneiform and bone contusion to the joint of the first metatarsal.  I was placed in an aircast on this foot, as well as an ASO stabilizing brace under the aircast.  On my left foot the MRI showed bone contusions to the lateral aspect of the foot, findings were concurrent with bone contusion to the cuboid bone, possible trabecular microfracture of the cuboid.  

I have put very little weight on my feet, none on the right.  I have put enough weight on my left heel to support my body as i transfer from wheelchair to shower/bathroom, etc...  Yesterday i did try (with a ASO stabilizer brace) to stand, twice, with support on a walker.  The left foot today is much worse.  I was told after four weeks a bone contusion should heal.  I am very concerned that the left foot is so sore.

Does the left foot need to be casted?  Would my right foot heal faster in a hard cast instead of an aircast?  How long can i expect to be confined to a wheelchair?  How much movement of the left ankle/foot is ok?  I have been getting in teh pool wtih it wrapped in an ace bandage and letting it float/gently move to prevent stiffness.  

I am delivering in six weeks, and it is imperative that i am walking by then!  Please help!

Also they had given me voltaren gel to use at the ER.  Is that preventing bone healing or should i continue to use it?

Answer
These sort of injuries are frustrating and painful, especially during pregnancy!  Your best bet is to be as immobilized as possible to promote healing.  The less motion around and more protection, the faster it will heal.  Add to that, your developing baby can be pulling calcium from you, slowing your healing process.  Healing of this sort should take 6-8 weeks generally.  You will need physical therapy to help you regain strength and balance afterward.  Again, lousy timing with a newborn.

The voltaren is fine to use, really the only thing for inflammation when pregnant.

Good luck with everything...I hope the rest goes smoothly and you recover quickly to enjoy the baby!
All the best,
Andrew Schneider, DPM

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