Stuff I Know

Just stuff by me about me and my life, such as it is.

Thursday, December 30, 2004

Not as bad as I thought ...

And definitely not as bad as it could have been. Turns out I have what is classified as a tuberosity avulsion fracture of the fifth metatarsal (It's amazing what you can learn on the Internet.). The doctor at the hospital called it a stress fracture, and in a way it is, but then he is probably just not up on the English terminology.

For those interested ... It is that big tendon, the peroneus brevis, that tends to hang on tight and snap the bone when you twist your ankle too far.
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This is not my x-ray. I was too busy trying to understand all the Korean the doctor was saying to ask for a copy of my x-ray. But it is fairly similar. Image borrowed from Medipix, Contributor: Richard P. Moser, III. Image Hosted by It is really hard to see the fracture there, but then it is the same for mine. The fracture is perpendicular to the long axis of the bone, shows very little separation, and does not extend all the way to the other side.

The doctor wanted to put me in a cast. In fact I think I actually paid for a cast. They make you pay for your x-rays and stuff before any of it actually happens. Once the doctor has a look at you and gives a first diagnosis, you head to the cashier to make sure any procedures required are paid for. I think it was only about $9.00 US for the cast, so I am not losing much money by not having it done. Actually, I talked the doctor out of putting me in a cast. He finally agreed saying I couldn't exercise, couldn't do some other stuff (not to sure about the Korean), had to take the pills, and then come back in a week. If there was any lengthening or widening of the fracture, then I had to go in a cast.

I figured it was a fair deal. After all it is better to be safe than sorry, but being overly safe can be a big hassle. All the information I read on the Internet, from medical, sports medicine, and medical advisory websites, says that conservative treatment is best for this kind of injury. That treatment includes compression wrapping, wooden soled shoes, walking braces, and similar items all aimed at getting weight back on the foot as soon as possible. One site even said non-casting is better to help decrease recovery time as compared to the muscle atrophy problems associated with casts. Here is one sites information on treatment:

A faster return to full activity is seen if using a wool/crepe bandage than if a below-knee walking plaster. Recommendations:
  • All avulsion fractures of the fifth metatarsal base should be offered symptomatic treatment only e.g. supportive bandage or tubigrip for 4 weeks.
  • Aim for early full weight bearing.
  • Further routine radiographs are not necessary.
  • Avoid plaster immobilization if possible.
So even tough I am not a doctor, I think I made the right decision for now. A cast is just really inconvenient. Ever try and shower with one? And I would rather not have to split all my pants up the side just to have them fit over the cast. It is already hard enough finding pants that fit well, here.

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This is my foot. If it looks a little swollen up toward the toes, that's because it's wrapped in an ankle compression bandage bandage all day, around the middle. That burise does look pretty bad though, doesn't it. It hasn't gone away yet, and it seems to come back everyday, even though in the mornings it does look lighter.

When I go back to the hospital about next Tuesday, I will try and ask the doctor if I can get a copy of my x-ray. I will also be sure to let you know how things are going. If I forget, just remind me.

The same hammer that breaks the glass forges the steel.
- Russian Proverb


At 7:08 PM, Blogger スロ / Bernat said...

D'oh! Good that's nothing important.

At 9:03 PM, Blogger スロ / Bernat said...

No news?

At 10:27 AM, Anonymous Anonymous said...

The problem with not isolating any 5th met fracture, including those at the apophysis (the area where a tendon inserts) is that the fracture fragment can pull away a bit as it heals and leave the peroneus brevis tendon a bit longer than it started. This will unbalance the lateral foot control via the PB tendon with the opposing tibialis posterior tendon (at the inside of the foot). If the lateral foot is a little more lax due to the PB tendon being a little longer, your chances of turning the foot in again and either fracturing the 5th met or breaking the ankle is that much better. Hopefully, you had some aggressive physical therapy after the injury to strengthen the site?

Best wishes,
Dr. David Secord


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