Extended proximal 5^th metatarsal fracture healing progression

This series of plain radiographs were taken of a high school cross-country runner who sustained an acute foot injury while training. Radiographs reveal a fracture of the proximal 5^th metatarsal involving both the intermetatarsal zone and proximal diaphysis that healed over the course of twelve weeks.

(Panel A) May 20^th; initial visit. Fracture lines were visible on radiograph (arrow indicates one example). Patient began treatment by wearing a boot and using crutches to remain non- or partial-weight bearing as pain permitted for 2 to 3 weeks.

(Panel B) June 9^th; 3-week visit. Patient described significantly less pain and was compliant with partial weight bearing. Fracture lines (arrows) remained visible on radiograph. Patient transitioned from partial to full weight bearing as pain permitted over the next 4 to 5 weeks.

(Panel C) July 15^th; 8-week visit. Patient felt markedly better. He used crutches for prolonged weight bearing only and otherwise felt comfortable in the boot. Healing callus (arrow) was visible on radiograph. The patient was told to wear the boot only when outside his home. He was permitted to swim but not to cycle.

(Panel D) August 8^th; 11-week visit. Patient described no pain with weight bearing. Fracture was largely healed on radiograph. Boot was discontinued. The patient was permitted to swim, cycle, and walk, but not to run. He was told he could begin walk-jogging in one month and warned not to increase the duration or distance by more than 10% per week over subsequent weeks.