Now where were we? Ah yes, we were talking about Kelly Ripa and her husband Mark whatever his name is and their matching lower extremity injuries and fracture boots. Of course that’s not to mention their matching biceps and flat abs. I mean seriously, that house is probably not the ideal place to get the munchies. But anyway, as you recall, Kelly broke some bones in her foot, and my best internet trolling has been unsuccessful in ascertaining exactly what bones she broke, but based on the nature of injury and treatment I’m going to surmise it’s a metatarsal fracture. What’s important here is the treatment of choice- weight bearing in a fracture boot for 6 weeks, or as Kelly predicts, three weeks.
We have previously discussed the use of CAM walkers, which is an acronym for controlled ankle motion in the past, but it’s been a while. In my NYC podiatry practice we give them out more than Gatorade at the marathon for various injuries. It’s a big drag, and mostly unnecessary, to wear a heavy restrictive fiberglass cast for an extended period of time. Fracture boots act to almost completely immobilize the foot against the ankle, reduce pressure on the bottom of the foot and allow broken bones, strained or torn tendons, or really inflamed plantar fascias to rest and heal while patients walk and remain active close to their normal levels. Why six weeks of rest? Who knows. Bone takes about 4-6 weeks to heal and that is a comfortable timeframe for most patients and doctors. In reality, the bone is mostly healed before that time and not completely healed until after that time. In six weeks most patients will be healed enough to walk in a comfortable shoe, but it’s a matter of clinical judgement based on each patient’s ability to bear pain-free weight, X-ray appearance and level of comfort of the treating physician. Kelly is young (yes 44 is still young, thank you) and healthy (quite), so she’s probably not wrong about three weeks, although I can’t say for sure since she went somewhere else for treatment (not so smart).
What we haven’t mentioned is the incidental finding of a calcaneonavicular coalition, which is a congenital fusion of two bones in her foot that had not previously been noticed or painful. Maybe we’ll stretch this topic into a third blog and talk about that one in the future if I’m really desperate for a topic. Meanwhile, my young patients, you have more than you wanted to know about fractures and their treatment. And seriously @KellyRipa, why would you go anywhere else?
See you in the office.
Ernest Isaacson
