From the Research
Treatment for a 19-year-old female with a non-displaced, small left 3rd metatarsal fracture that is painful to walk on but without swelling should focus on conservative management, with the patient placed in a walking boot or stiff-soled shoe for 4-6 weeks to immobilize the fracture and allow proper healing, as recommended by the most recent and highest quality study 1.
Key Considerations
- The patient should be allowed weight-bearing as tolerated with the supportive footwear.
- Pain management should include acetaminophen 650mg every 6 hours or ibuprofen 400-600mg every 6-8 hours as needed for pain, not exceeding maximum daily doses, as suggested by general medical guidelines.
- Ice application for 15-20 minutes several times daily for the first few days will help manage pain and any developing swelling.
- Elevation of the foot when sitting or lying down is also recommended to reduce swelling.
Follow-Up and Rehabilitation
- After 4-6 weeks, if pain has subsided, gradual return to normal footwear and activities can begin.
- Physical therapy may be beneficial during this transition phase to improve mobility and strength.
- Follow-up imaging at 4-6 weeks should be performed to confirm healing, as indicated by the study 1.
Rationale
The conservative approach is appropriate because non-displaced metatarsal fractures typically heal well without surgical intervention, and the bone's alignment is maintained, allowing for proper healing with protected weight-bearing and time, as supported by the evidence 1.