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Jones fracture, 5th metatarsal questions

post #1 of 3
Thread Starter 
On 7/14, my wife suffered a Jones fracture of the 5th metatarsal, left foot. She was placed in a walking boot. According to subsequent x-rays at 2 weeks and 4 weeks, she was healing well.

On 9/1, she tripped over something in our home, and was in severe pain, this time toward the anterior end of the same 5th metatarsal and the rest of the forefoot, with a new tingling sensation along the entire plantar surface. X-rays that day proved negative. She went back in the boot for two weeks, and with pain greatly reduced (but tingling remaining), she was cleared to start PT.

Two weeks later, her PT had a "technician" overseeing the therapy, including a new exercise. After this session, my wife could barely walk due to forefoot pain. This improved a bit with ice, but two days later when the PT examined her foot, she thought she detected a neuroma between 3rd and 4th metatarsal. Went back to ortho, who could not detect it with palpation.

Since then, she has 1) gotten a second opinion from another ortho who had no new input 2) started using metatarsal pads in her shoes, with intermittent improvement and 3) had an MRI, which showed no neuroma, but the report summary was as follows...

Diffuse patchy marrow edema throughout the metatarsals and tarsals, most prominent within the 1st and 5th metatarsals, as well as the cuboid and calcaneous. No underlaying fracture or TI signal abnormality is present. This finding is nonspecific and may represent altered biomechanics.

The ortho has not provided feedback yet (he gets the report tomorrow).

Is this situation where it is simply fluid buildup that should resolve with PT, massage or Active Release Therapy, or should another avenue be explored?

post #2 of 3
have you talked to a podiatrist?...it says you're dealing just with orthos.
A podiatric surgeon would probably be a better source for a second opinion (or the initial treatment for that matter) when dealing with lower extremity breaks/ treatments. Did the ortho order t2 studies? sometimes the pathology shows up better with them.....
post #3 of 3
Thread Starter 
Thanks, Mak... she consulted with a new ortho, foot specialist, and he informed her that the setbacks she is having are normal. And it's not a Jones fracture, but an avulsion fracture. The pain level has diminished quite noticeably in the last four days, and she has commenced working with a new PT, also a foot specialist who has lots of interesting ideas and methods.

Forty seven days till Tahoe...
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