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Foot Care (Podiatry) Forum
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2nd metatarsal base fracture

I fractured the base of my 2nd metatarsal in mid August but did not get a "correct" diagnosis until beginning of October because it isn't visible on x-ray. My sports doc sent me for an MRI because I have a history of stress fractures (previous stress fracture to femoral neck). MRI findings were subacute osteochondral injury & small incomplete, nondisplaces fracture to base of 2nd metatarsal, mild joint space narrowing to 2nd joint but no subluxation/dislocation. Small subacute osteochondral injury to lateral cuneiform. No damage to lisfranc/tarso ligaments. Referred to a podiatrist who performed weighbearing x-rays. Fracture was not visible nor was any joint seperation found.Treatment thus far has been crutches, cam walker, and bone stimulator for 3 weeks. At followup, doc allowed me to go back into sneakers because repeat x-rays did not show fracture/joint seperation and I did not feel pain when he manipulated my foot. I tried my sneakers for a few days but couldn't go more than a few steps without a sharp pain at the top of my 2nd metatarsal shaft. Went back to the boot which has provided limited relief but still feel pain. I am concerned that the fracture isn't healing and I am doing more damage. What is proper treatment for 2nd metatarsal base fracture? Weightbearing x-rays & MRI don't show lisfranc injury but could the MRI be wrong? What do the osteochondral injuries mean? Docs don't seem to be concerned about them but also can't provide me with much info either. Podiatrist said it could be an incidental finding which tells me he doesn't know. I am a 25 year old female that used to be active. I am going to an orthopedic foot & ankle specialist for a 2nd opinion so not looking for a diagnosis but additional info/advise would be very much appreciated.
1 Responses
681547 tn?1227149574
MEDICAL PROFESSIONAL
the 2nd metatarsal base area  bears a lot of weight when the foot hits the ground.  we call it the "key stone" of the foot.
if there was a fracture at the base (intra-articular), then you could have arthritis in the area.  i typically have the patient wear a surgical boot for 6 weeks and then transition to a stiff sole shoe (surgical shoe).  if the patient continues to have pain when in a shoe and orthotics after 3 mos from date of injury, i fuse the joint (the base of the 2nd metatarsal to the cuneiform).  patients typically do well from then on.
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