Question
I have a displaced 5th metatarsal fracture of the right foot. I went to the ER and was given an aircast. This was followed up with a visit to an ortho surgeon the following week. I was given the impression that all was wall. X-rays were taken on both visits. This injury occured almost 2 weeks ago. My own family doctor wanted to see me to follow up and he was angry that they gave me a walking cast. He took more xrays and said that there is no calcification, hence no healing. It is still very bruised and he said that this was because I am walking on it. He has given me instructions for rest and NO walking on it (crutches only). I don't know what to think. Should I see a podiatrist? Do I need surgery? Do I really need to stay off of it or is my doctor an alarmist? Thanks so much in advance.

Answer
Hi Erin
there are different types of 5th met fractures.  I don't know the exact nature of your fracture, and how displaced it is.  There are fractures at the base of the metatarsal which have their own classification and depending on what category of fracture you have the treatment and prognosis are different.  There are also fractures of the mid shaft of the metatarsal and fractures of the neck and head of the metatarsal.  The treatment and the decision to do surgery depends on where the fracture is, and  how displaced it is.  Quite often we surgically fixate the displaced 5th met fractures to reduce healing time and also to obtain correct anatomical position of the foot.  Unfortunately since i have not seen your x-rays, I cannot tell you what course of action would be the best for you.  
Keep in mind that a fracture needs at least 2 to 3 weeks to show healing on the radiographs.  The non wight bearing is a good idea.
You should visit a board certified podiatrist for a second opinion.
good luck
Isaac Tabari DPM
www.footdocnyc.com
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