FRACTURES OF THE FIFTH METATARSAL

What is a Fifth Signs and Symptoms areas of the foot to determine where Metatarsal Fracture? Avulsion and Jones fractures have there is pain. ractures (breaks) are common in the same signs and symptoms. These The surgeon will also order F the fifth metatarsal—the long include: x-rays. Because a Jones fracture bone on the outside of the foot that • Pain, swelling, and tenderness on sometimes does not show up on connects to the little toe. Two types the outside of the foot initial x-rays, additional imaging of fractures that often occur in the • Difficulty walking studies may be needed. fifth metatarsal are: • Bruising may occur • Avulsion fracture. In an avulsion Treatment fracture, a small piece of bone is When it is not possible to see a foot pulled off the main portion of the and ankle surgeon immediately,the bone by a tendon or ligament. “R.I.C.E.” method of care should be This type of fracture is the result performed. This involves: of an inversion injury,in which • Rest. It is crucial to stay off the the ankle rolls inward. Avulsion Head injured foot, since walking can fractures are often overlooked Neck cause further damage.

when they occur with an ankle Mid-shaft (stress) • Ice. To reduce swelling and pain, sprain. fracture apply a bag of ice over a thin Jones fracture • Jones fracture. Jones fractures towel to the affected area for 20 Avulsion fracture occur in a small area of the fifth minutes of each waking hour. metatarsal that receives less blood Do not put the ice directly against and is therefore more prone to the skin. injury.A Jones fracture can be • Compression. Wrap the foot in an either a stress fracture (a tiny elastic bandage or wear a hairline break that occurs over compression stocking to prevent time) or an acute (sudden) break. further swelling. Jones fractures are caused by • Elevation. Keep the foot elevated overuse, repetitive stress, or to reduce the swelling. It should trauma. They are less common be even with or slightly above the and more difficult to treat than Diagnosis hip level. avulsion fractures. Anyone who has symptoms of a fifth metatarsal fracture should see a foot Options for treatment of an avulsion Other types of fractures can and ankle surgeon as soon as fracture may include: occur in the fifth metatarsal. possible for proper diagnosis and • Immobilization. Depending on the Examples include mid-shaft treatment. To arrive at a diagnosis, severity of the injury,the foot is fractures, which usually result the surgeon will ask how the injury kept immobile with a cast, cast from trauma or twisting, and occurred or when the pain started. boot, or stiff-soled shoe. Crutches fractures of the metatarsal head The foot will be examined, with the may also be needed to avoid and neck. doctor gently pressing on different placing weight on the injured foot. • Surgery. If the injury involves a time because these fractures take heal through immobilization and displaced bone, multiple breaks, longer to heal. bone stimulation. or has failed to adequately heal, • Bone stimulation. A pain-free surgery may be needed. external device is used to speed If surgery is required for treatment the healing of some fractures. of a fifth metatarsal fracture, the foot Options for treatment of a Jones Bone stimulation may be used as and ankle surgeon will determine the fracture may include: part of the treatment or following type of procedure that is best suited • Immobilization. As with avulsion an inadequate response to to the individual patient. L fractures, initial treatment may immobilization. involve immobilization, but • Surgery. Surgery may be needed, typically for a longer period of since Jones fractures often do not

ARCpodiatry.com

This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 6,200 foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards. Copyright © 2007,American College of Foot and Ankle Surgeons • www.FootPhysicians.com