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Dr. Andrew Rynne

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Had got fracture on metatarsal and ankle. Why am I getting pain at fractured site?

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Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

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Posted on Fri, 25 Jan 2013 in Bones, Muscles and Joints
Question: I broke my 5th metatarsal and ankle on 13 July 2012. An MRI taken on 21 December 2012 revealed nothing remarkable. However, I am still unable to wear shoes on the broken foot because it hurts on the top and bottom of my foot in the area of the metatarsal fracture. I don't need to even walk or put weight on the foot - just 15-20mins after putting a shoe on (or slipper - I have tried different shoes and slippers. Flip flops aren't an option either as my toes hurt to grip) the pain is there no matter what shoes I try to put on. This has been going on since September. I just can't seem to move into shoes.

The surgeon has advised me to wear orthotic insoles for the next 3 months and to see how that goes. I am progressing well with physiotherapy and the foot seems to be both stabilizing and strengthening, although this is mainly because I have found a way to walk, which is pretty much on the other side of my foot and still limp a bit. Barefoot is like a different world. I limp but I get around ok and I am not in pain. But as I put shoes on, neither foot is ok and my broken foot is really not ok and in considerable discomfort. So when I go outside, I still need crutches just to cross roads safely and get on and off public transport etc.

I am out of the orthopedic boot, though - I started to have pain in my knee and hip and the physio was keen to have me out of that to help my ankle heal. The best pair of shoes is a pair of bare feet trainers; this is the only pair that makes the pain bearable. Normal shoes are impossible. But even the barefeet trainers still hurt, again pretty much after 15-20mins of having them and always in the same area - in the area of the metatarsal. The pain is slightly different above and below. Below it hurts to put weight on. But it's the pain above the fracture that is the real problem. I take them off whenever I can.

I don't know what to do and I am just seeking a second opinion. I am trying to be patient and I am very happy to avoid surgery. But I am not confident in my surgeons I have been seeing at the fracture clinic, mainly because none of them seems to have any time and I also keep seeing a different one, who just looks at the last lot of notes. I feel I am just going from pillar to post without anyone really reviewing my case thoroughly. However, I also don't know what's normal or expected - maybe not being able to wear shoes 6+months later is not unusual and another 3 months with insoles might do the trick after all. What do I know!? So I just keep telling myself that they must know what they are doing and to go with what they are saying. But XXXXXXX down I am worried that something is being overlooked and waiting another 3 months is just going to further effect the biomecanics even further - my other foot is not in serious pain so now both feet are unable to walk normal; and the pair of shoes that is bearable for my broken foot is terrible for my other foot, which needs more support. I don't know what to do. If you have any suggestions, i would be very grateful in any advice you may have.
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Answered by Dr. Saurabh Gupta 2 hours later
Hello,
Thanks for writing to us.

I went through the details submitted with diligence. I can understand your problem.Normally fracture of metatarsal take 3-5 weeks for union , if they are in proper alignment and proper immobilisation is given.

Now after 6 month if pain and tenderness is still present at fracture site, there is chances of delayed union or non union. So I advice you to get a recent X-ray of foot done so that status of fracture union could be seen.You can upload your recent X-ray to allow me to help you in better way.

I hope this answers your query. I will be available for further guidance if you needed.

Wishing you good health...
Regards.
Dr Saurabh Gupta.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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