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Given knee air cast for broken metatarsal, swollen foot and ankle. How do I use the air cast properly?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10401 Questions
Three and a half weeks ago I broke my 5th metatarsal on my left foot (clean break, not displaced). It is not a XXXXXXX fracture. I am a 61 year-old female. I was given a tall to the knee air cast by the second MD that I have seen. She seems like a good M.D. I am writing because my foot and ankle are still swelling somewhat: comes and goes which confuses me. One orthopedic MD (first one who I didn't like because he never gave me eye contact or touched my foot) said no weight bearing for three more weeks (it had been broken for 10 days when I saw him). The MD I saw a week later said I could put weight on my foot if I use the air cast. She thought I could walk right away if I use the air cast. I have been very slow to put weight on my foot because it hurts. I figure I need to be patient with myself. I do have to occasionally put some weight on it just to stand near the sink, etc. or to keep from falling etc as I get around the house. (I also use crutches). My questions: (1) how do I use the air cast properly? The MD said it was up to me if I want to sleep with it or take it off. If I take it off what should I do with my foot? Do I wrap it or what? (2) I am not sure I am using the air pump and filling the cast up correctly. Should it be tight? Or, semi-tight? If I am not walking, but just putting some weight occasionally on my foot to stand occasionally, does it matter? I hope you can answer me right now. My foot is somewhat swollen. I use the cast a lot. Right now as I write to you, I have my foot out of the cast because it was beginning to hurt. I am confused to why the swelling comes and goes. Do you know why the swelling comes and goes? What should I do about this? Is ice still a good idea? I used ice the first two weeks. Now it has been almost four weeks since I had the accident. Should I be attempting to move my toes and do any foot stretches at this point in time? I have been careful not to move my foot. It feels stiff and doesn't really want to move. I hope you can write asap.
Posted Wed, 5 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
1. You can take off the cast while sleeping and keep your foot on two pillows to decrease the swelling while resting. There is no need to wrap the foot in anything.
2. You can keep the air level at semi-tight so that it is comfortable for you when you walk on it. You can put your weight on it all the time as you feel comfortable. Gradually you will feel comfortable with it and walk properly.
The swelling is mainly because of the injury and due to the gravity. Try to keep your feet on a stool rest while sitting. You can do a hot fomentation in the area for an early healing.
You can move your toes but foot stretches are not advisable till the healing is complete.
Taking mild serratiopeptidase and calcium supplements will help in early healing and decreasing the swelling. You can get these prescribed from your orthopedician.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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