Broken foot bone - reduced blood flow - treatment?

[sourpatchkid]

DH has a fractured foot bone (he can’t remember which!) the treatment and waiting times have been appalling (it’s been 3 months since his first appointment) they’ve finally done all scans etc and say he will need physiotherapy - which will be in 5 weeks time! We can’t keep waiting, we have a young Baby and DH is now barley mobile and unable to help (and getting depressed because of this)

Can anyone tell me what treatment was suggested to them and any tips of what physiotherapy might do?

Would aspirin help for blood flow?


(He has crutches and elevates foot already)

Thank you 😊

[PurplePillowCase]

can you afford a few sessions of private physio?
if yes, do that (probably 50-80£ per session)
they wil do sn assessment and a special massage to improve blood flow/reduce swelling.

[sourpatchkid]

Thank you, we can but we’ve had trouble finding one (we are quite rural) I’ll look again 😊

[JohnHunter]

Is it a stress fracture? I can't think what else wouldn't already have healed within three months. If there is a break that isn't yet healed, aspirin won't increase the blood flow but might have the opposite effect of slowing bone healing. There isn't much anyone can do to promote bone healing unless they are a smoker and in which case they can stop smoking...

[sourpatchkid]

Thanks 😊 No he doesn’t smoke. I think it’s a stress fracture but he didn’t take all the details. All I know is they said he has reduced blow flow to the bone which is why it isn’t healing and I wondered if aspirin may help that?

[JohnHunter]

Then it's probably a Jones' fracture if the pain is on the outside of his foot. There is a small area of the fifth metatarsal where the blood supply is notoriously poor for everyone and up to a third don't heal. Aspirin will make things worse if anything. Is he in a plaster or walking boot?

[sourpatchkid]

Don’t heal? What ever? How will he manage forever like this?

NHS have offered no treatment so far. We’ve bought crutches from amazon which he uses and also a moonboot which he says doesn’t help so hasn’t used

So no aspirin - is there anything he can do to help?

[sourpatchkid]

(I really appreciate your time by the way)

[JohnHunter]

Well they sometimes don't heal without help, i.e. an operation. It's odd that he's not been offered anything (e.g. a walking boot) if it is a stress fracture. Who has he seen about it so far?

[sourpatchkid]

We will pay for private surgery if it’s the right thing (we don’t have lots of spare cash but could put it on a credit card)

He’s been offered nothing, I’ve been really shocked at the care. He’s seen 3 GP, had an x ray and an mri. Saw the fracture clinic today but that’s it

[PurplePillowCase]

has his gp done a 'bone profile' blood test & vit d3?

[sourpatchkid]

No,nothing like that.,can he get it privately ?

[PurplePillowCase]

probably.
tbh I would either ask fracture clinic or gp for it.
private blood tests are expensive though (plus fee for consultant who orders it and the nurse who takes it...)

[sourpatchkid]

We’ve had really poor care from everyone so far, I seriously doubt they would offer this.

He was going to take vitamin d anyway, what else does it test for?

[PurplePillowCase]

www.reference.com/health/bone-profile-blood-test-7dec06172114366f#

it looks for bone metabolism in the blood.
dc had one when a 'break' didn't heal. (turned out to be something else)

[JohnHunter]

A bone profile is just a test for various salts in the blood (calcium, phosphate, etc). These things don't really affect healing. bone It's not something I'd request for a patient with a broken bone, even if it wasn't healing well. The same goes for vitamin D. It would only really be different if he kept breaking bones or had sustained a break (e.g. hip, wrist) from a minor injury and I wondered about osteoporosis. Certainly don't pay for any blood tests.

If he has been seen in fracture clinic then it's unlikely that he's receiving the wrong treatment. It is probably worth giving them a call and asking for an earlier follow-up as you obviously have questions that need answering. This wouldn't be a problem at any fracture clinic I've worked at and we would probably book him in to be seen in the next couple of days.

I think these questions are best directed at someone who can see all the imaging (?stress fracture ?avulsion fracture, which bone, evidence of healing on MRI, surrounding soft tissue damage, etc).

[sourpatchkid]

That’s really helpful, thank you.

[VivienneWestwoodsKnickers]

In looking at private orthopaedic surgeon appointments for my DH and his knee. It's about £150 here. You could see how you go about using his xray and mri results to take you such an appointment?

[sourpatchkid]

Thank you. Can he just ask for copies of them? (He didn’t write anything down)

[JohnHunter]

There will normally be a form to complete and a nominal fee to pay the hospital for admin costs, photocopying, and transferring images to CD. Most private consultants will also require a GP referral, although few GPs will object to doing this. Unless money isn't an issue, I would go back to fracture clinic first. It would be disappointing to pay £150 (private consultations come in at £250 in a lot of places) to be told the same as you've already heard in the NHS.

[Bluntness100]

I’m surprised he doesn’t know what kind of fracture it is. I broke my ankle in two places, was in a&e in one area a couple of hours away from where I live then fracture clinic close to home, I saw x rays, was explained what I had, was given a frame them crutches, two different kind of casts and then a walking boot. After each visit a letter was written to my doctor, cc myself, explaining what I had and what the treatment would be until thr next visit.

I’ve seen everyone from nurse practioner to registrar to orthopaedic consultant, and each one of them I could ask questions of.

I’ve also previously broken my foot, and befor that my toe twice, and have been in varying hospitals from Scotland to Surrey (accident prone clearly) and I’ve never heard of anyone being given no walking support like crutches or not knowing what’s wrong with them.

He should have been told what medication to take for pain, been offered pain killers, walking support and have letters coming to his home explaining what the issue is. The treatment he’s getting is really unusual.

[TonicAndTonic]

OP you say he is elevating the foot, but is he definitely elevating it high/often enough? I fractured my 5th metatarsal some years ago and was told that because of the low blood flow to that area, every time I was seated my foot needed to be level with or slightly above my pelvis to make sure the blood didn't pool in the foot area. It was a massive PITA but it did heal eventually.

I was given a cast then a moonboot up to the knee despite it being a tiny fracture, I found the moonboot good but you have to make sure it's pumped up enough, and resist the urge to keep taking it off all the time!

[sourpatchkid]

Thanks Tonic. That’s really helpful

And I agree bluntness I’m surprised too, but then my maternity care in this area was terrible too so... sometimes care just isn’t that good?