Hospital missed fracture in foot

[FootPalaver]

Name changed for this because it's potentially identifying.

My partner recently suffered a nasty injury to his ankle, and needed surgery to repair the damage. At the time his other foot and ankle were X-rayed as that foot was also painful, swollen and very bruised. He was assured there was no fracture in the foot with the non-broken ankle. Understandably, most focus was on the ankle broken into bits.

Discharged from hospital, sent home, told to remain non weight bearing on the injured leg for 6 weeks. He's been minimally using the other foot to move around the house, go up and down stairs but it was painful from the start and has remained painful, possibly got worse.

Couple of days ago we went back to get the stitches out. We travelled by public transport (long way and no car) and the pain in the non stitched foot was excruciating. He asked the doctor to look at it, doctor ordered a new X-ray which revealed that there was indeed a fracture, 5th metatarsal, and displaced due to the fact that he's been walking on it. So now he's due a CT scan and may need surgery to correct/repair it. This doctor was lovely and very apologetic, said that if this fracture had been known about he would not have been discharged when he was.

Is it common for fractures of this type to be missed first time round? When he had the original x-ray his foot was a bit swollen, could that account for it? It got much more swollen later.

There's no turning back the clock of course but he's feeling pretty low about the prospect of more surgery. Also it's possible that this will always be painful and possibly arthritic in the future.

The fracture clinic didn't give any advice about what he is supposed to do while waiting for the scan, be completely non weight bearing? The original surgery was only 2 weeks ago. The scan is early next week. Really don't want to be doing bed pans 🤦🏻‍♀️🤦🏻‍♀️

Help, I'd appreciate any thoughts, experience etc. please!

Unfortunately it can be easy to miss a hairline fracture on both metatarsals and meticarpols (sp) due to the shape and size of the bones and swelling can make it more difficult to see.
I would assume that because he's been putting all his weight on it rather than the broken ankle which has caused it to become a displaced fracture (which are very easy to see on an x-ray) hence the possible operation.
As for the pain and arthritis in the future I'm not a dr just a regular visitor to the local fracture clinic who can only give you anecdotal response of there being a very good chance the he will have a weather ache from now on but that can come with even simple breaks not just bad ones (had plenty of both)

Just to say non weight baring means not walking on it he can crawl if not to painful or sit on a skateboard and use his hands to push himself around. Stairs can be more tricky and takes a bit of practice you go up backwards on your bum and lift yourself up backwards with your hands 1 step at a time trying not to jostle your broken limb to much. You look like a complete twit but it works😆

Thanks for the reply @Hoardasurass
Sounds like you have lots of personal experience! Thanks for confirming that they are easy to miss, it makes sense.

Do you reckon he should be trying to be completely non weight bearing at the moment then?

My MIL had this happen, broke one leg and the break in the other was missed.

She got around the house on a wheely office chair

Yes but not immobile as you risk blood clots. Crawling to and from the bathroom (if he can) is a good way to be moving for both of you, him less chance of clots and you no bed pans so win win. He would need to sit to pee though stay on the same floor as the bathroom

I fractured a 5th base metatarsal 7 years ago. The eagle eyed clinician spotted it luckily & showed me it, she said they can be very hard to spot. Mine was a tiny almost indiscernible hairline crack & I was put in a walking boot for 6 weeks. It throbs at times and definitely get a weather ache & nerve pain. Hope he is ok op.

@FatEaredFuck
Oh dear! I do have a wheelie chair actually! Will suggest 😊

Yes blood clots, that's true, he's been given the blood thinners but still. Crawling, wheelie chair all good ideas. Thank you.

@CherryRipe1 Thanks and sorry to hear about your fracture. I'm thinking with two buggered legs he'll be having many a twinge in the future sadly.

If the fracture on the other foot, on the 5th metacarpal was subtle enough to be missed on early X-rays, he's unlikely to need to be immobile.

I'd suggest it isn't him walking on it that's made it worse, it's just that later X-rays might reveal a # that wasn't obvious on the initial images.

@Fordian Thanks for that. There was a little bit of bone poking up that presumably wasn't to begin with, that's why we assumed it was from the walking on it. Dr in Fracture Clinic was aghast that he'd been sent away and was walking on it for a couple of weeks, not much walking but putting all his weight on it.