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Sunday, August 3, 2014

2nd Metatarsal Fracture: Email Advice

Hi Dr. Blake,
On July 8, 2014, I was filling my car up with gas with the automatic trigger on when the gas nozzle rocketed upwards and then nose dived onto the top of my right foot.
Because the swelling was so severe, the radiologist in the urgent care center did not detect the break on the x-rays taken there.
When I first visited my orthopaedic a few days later, he relied on the urgent care center x-ray and validated the contusion diagnosis.
After noticing that my second toe had lifted and was curving a bit towards my third toe, I returned to my orthopaedic and asked that he take x-rays.  After review, he immediately found that the metatarsal was broken.
One doctor says have surgery.  Another says not to.
I train 5 days a week with a trainer and have run 39 marathons so full use of my foot is critical to me.  I also enjoy running stairs.

I've attached the x-ray that indicates the break and a picture that I took of the hit within minutes at the gas station.
What is your recommendation?

With a heartfelt thank you for honoring Dr. Roy Corbin,
Sharon (name changed)



Dr Blake's response: 

Hey Sharon, how did you know Roy? He was an unbelievable person. I get great joy, and sadness, looking at him every time I open my blog. What a loss!! You definitely have a bad break, which takes a long time to heal conservatively, and yours will heal crooked. I would have that rebroken and fixed once the swelling is gone. With your athletic goals, I would not take a chance at poor healing. The 2nd metatarsal takes the most pressure at the start of push off before the weight is transferred to the big toe. You need this stable and strong. It will heal in 6-8 weeks with surgery and 6-8 months possibly without surgery, even if you get a bone stimulator to use. But, you will need to be off running alot longer than that. I hope this helps. Let me know any thoughts or what happens next. Good Luck. Rich

And the patient's response:

Hey Dr. Blake,

Thank you very much for sharing your expertise.
Dr. Donald Baxter, the famous doctor regarding Baxter's nerve entrapment, examined me last week as I live in Houston, Texas.  He generously spent 45 minutes with me but, at the end, was a bit conflicted so we agreed that the best plan of attack was to seek other experts' opinions.  We were leaning towards surgery but figured waiting another week would not hurt.
I came across your video regarding how to pull back and wrap the second toe.  After watching that video and studying other videos and analyses of cases that you have posted, I felt like an old friend so I emailed you!
Sadly, I did not know Dr. Roy Corbin.  However, since you dedicated your blog to him, I Googled his obituary so I could better understand and appreciate your inspiration.  Alas, after reading such a beautifully written obituary, I do.
Please know that you continuously honor Dr. Corbin by not only dedicating your blog to him but also by helping patients near and far.  Most significantly, you honor him with your thoughts of him and heartfelt actions because of him.
I look forward to updating you later this week.
With my kindest regards,

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.