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Fractured first metatarsal in child

My 11yr old daughter has “an undisplaced hairline fracture running obliquely through the shaft of the first metatarsal” (left foot). This injury was caused by a horse standing on her foot.
The doctor first put a half plaster cast on her to ensure the swelling had run its course and which came off after 3 days. She is now in a knee to toe plaster cast supposedly for the next 3 weeks. The cast has become quite loose and she is complaining of abrasion now on the back of the ankle.
I have been reading on the web that the an injury to the first metatarsal should not be set in plaster. It should only be strapped.-Should the cast be taken off because it should not be plastered?-If the cast comes off, how long should her foot be strapped for?-If the cast stays on should her foot be strapped when it comes off in 3 weeks and if so, for how long?-If the cast stays on should it be redone because it is so loose now?-I also read that any bandage should not be worn at night. Is this valid?Any advice would be much appreciated.
Worried mumLouise


1 Comment found

    Vivian Abrams DPM

    9 10

    I understand your concerns for your daughter. First of all, medical information found on the internet can be confusing and even sometimes misleading. I would disagree with the statement that this fracture should only be strapped. I think it is most appropriate to immobilize the foot, so healing can occur properly. As far as the plaaster getting loose, that is something that happens with this material. The doctor who put it on needs to be informed. Possibly a cast brace might be an option, which would allow for bathing. This might depend on patient compliance too. After an appropriate time, your doctor might X ray her foot and see if bone callus and healing are occurring. Whether strapping the foot is indicated or not is a judgement call. These are concerns you should clarify with your doctor. Good luck.

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