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Am I more at risk of blood clots if I have a broken fifth metatarsal fracture and go on a long-haul flight?

Orthopaedic Surgery

Hi,

I broke my fifth metatarsal about 2 weeks ago (11/11/2017) and wore a plaster cast for 2 days before changing into an air boot. I’m allowed to bear weight on my heel according to the doctor. The swelling and bruising of my foot has come down pretty much and the fracture has been painless (except the first 2 days of fracture). I read that fifth metatarsal fractures can take a very long time to heal and are quite complicated as compared to other types of fractures. Also, I have read about the risk of getting blood clots from long haul flights. I’m travelling to Europe for a month for a family trip on 10/12/2017 and I would like to ask if it’s advisable to do so? When I went for my first consultation with the orthopaedist, he said it wasn’t a bad fracture so is it possible that my fracture would have healed before my trip and I would be allowed to weight bear on my foot before my trip? And does age and nutrition plays a factor in the speed of bone healing? I’m a female about to turn 21 in December and I have been eating lots of food high in calcium, protein and vitamins in hopes to speed up the healing process.

DOCTOR’S ANSWER (2)

Thank you for making contact and I can understand your concerns.

It seems there are two issues here:

Firstly your concerns about blood clots, or what is medically known as deep vein thrombosis. Immobilisation can be a risk factor, together with others including a previous history of clots, being on a combined oral contraceptive, various auto-immune conditions and also if you smoke.

Then there are the flight factors such as being in a cramped cabin, drinking alcohol and the flight duration. Indeed, there are many!

If you have concerns, its best to consult a physician before making a long-haul flight and they can give your risk profile.

They can also advise you on measures to limit risk. Simple ones that are often advised by travel companies includes ensuring you have a good fluid intake, use compression stockings, consider more leg-room and medications if appropriate.

Things to watch out for are pain, swelling and redness to the calf – this can be associated with sharp chest pain or difficulty breathing.

The second issue is the healing of your foot injury. Without seeing your images, examining you clinically and assessing your risk factors for healing, then it’s hard to give you more definitive information.

Nevertheless, there are things to consider when dealing with an injury:

  1. The mechanism of injury – how you hurt yourself
  2. Whether you have other risk factors that affect healing such as

a.  A poor metabolic state e.g. diabetes, obesity, peripheral vascular disease

b.  Whether you smoke

c.  Your general level of fitness

d.  Medications that may be taking

These all need to be taken into consideration when advising you about tissue healing and your prognosis.

If your doctor has advised about exercise, then I would follow that for the present time.

If you have concerns or questions, you should speak to your specialist before seeking another opinion. Safe trip and enjoy your family holiday!

1415 views 26 Jan 2018

Sorry to hear about your foot. Yes, long haul flights and bone fractures are both risk factors for blood clots, amongst other factors.

You should take the necessary precautions against developing clots if you do decide to travel. Overall however, the likelihood of developing a clot, in the absence of any other significant risk factors is likely to be low.

Having said that, you should definitely direct this line of questioning to the doctor looking after you, especially with regards to healing and weight bearing.

As a young and fit individual, recovery and healing in general is definitely quicker, and having a well balanced diet does help.

You should also consider some form of physio to help with the recovery process. This helps to maintain flexibility of your foot, decrease the amount of swelling, and stimulate tissue healing.

Again, go with the tailored advise of your doctor where exercise is concerned. As a general rule of thumb, patients with 5th metatarsal injuries can start with simple exercises on a bike or at the swimming pool by 4 weeks. You should consider this, but do monitor for discomfort or further swelling. Full activities can typically be resumed by 8 – 10 weeks.

Cheers

1388 views 26 Jan 2018
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