Fractured metatarsals and Smoking

24 years old, Male

I drank far too much a month ago and fell out of a cab while on vacation, making a hairline fracture across my 2nd, 3rd, 4th metatarsals.  I was in a fiberglass splint for 2 weeks, got more XRays, and was put in a fiberglass cast for 2 1/2 - 3 weeks.

I went back today, got more xrays, etc and I opted for the Cam(?) walker boot.  The doctor insisted I not put weight on it still, and scheduled me another appointment.


He said the 4th bone has healed, but the other 2 have shown little improvement (4wks total after accident).
He seemed to be inclined that it's taking longer because I am a smoker, and therefore scheduled me for another appointment 4 weeks from now, instead of 2 weeks.  

The question(s):
Would it be pointless for me to schedule an appointment in 2 weeks anyways, just for dumb luck that I might be healing quicker than expected?
I have been wanting to quit smoking for years now, and the fact that it might be preventing faster healing has finally made me decide to quit.  Will this help the healing time, or is the damage done already?

Will I most likely need phsyiotherapy after my foot is free from whichever shackles I'm in?  Is there anything i can do right now (maybe take off the boot and stretch?)

Is it beneficial at all to use the boot to walk sometimes, or is there just a risk of more damage?

Thank you

[S. Kaul, MD]

Hi there!

Well, it wouldn’t do any good to make an early appointment, since probably going by the healing progress it is expected take time. Even if you do, you would probably need another appointment in another 2 weeks.
Yes, quitting smoking would definitely help with the healing process, though one would not expect this to be as good as a non-smoker.
Yes, you would probably need physiotherapy to help with the movement.
Yes, you could stretch but one should take care to limit the movement to the ankle, supporting the foot at the base and avoid any movement or weight bearing beyond the ankle. This best done under the guidance of a physiotherapist and I would not really recommend doing this by yourself.
It is advised to be completely non-weight bearing and strictly follow your doctor’s advice. Non-compliance to this may further delay/ prevent adequate healing.
Hope this was useful.

Take care!