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"Is surgery recommended for 5th metatarsal bone fracture?"


38yo female s/p recent fall off the stairs. X-ray taken in ER showed oblique comminuted fracture of the diaphysis of the 5th right metatarsal. Would you recommend a surgery considering that the fracture is comminuted?


Fractures of the 5th metatarsal bone are, unfortunately, rather common and I am sorry to hear that you are dealing with this. Fortunately, you did not otherwise injure yourself in the fall. Many simple fractures of the 5th metatarsal bone are treated conservatively, meaning you might be placed in a hard boot to protect the foot and keep the bones for moving, often for a month or two before complete healing occurs.

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A comminuted fracture, however, is not necessarily simple. Depending on the degree of rotation of the fracture and any possible displacement of the bone, this fracture may require surgery. Given the fact that you are asking the question, I presume that the decision was made in the emergency room not to perform surgery. Probably this means that you were sent home in a walking boot and with instructions to follow up with orthopedics. The most important thing, therefore, will be to keep these orthopedics appointments. They will presumably follow you closely for pain and swelling and for signs of bone healing. With luck, things will heal up and you will not require further intervention. But, if the bone does not heal, your orthopedic surgery doctors may decide that you need surgery to more permanently fix the fracture.

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