Fractures of the Fifth Metatarsal

Fractures of the Fifth Metatarsal

What Is a Fifth Metatarsal Fracture?
Fifth metatarsal fractures, or breaks, are common foot injuries. This bone, located along the outer edge of the foot, connects to the little toe. Two common fracture types include:

Avulsion Fracture: This occurs when a small bone fragment is pulled off by a tendon or ligament, usually from an ankle roll. These fractures can often be missed when paired with an ankle sprain.
Jones Fracture: Jones fractures occur in a small section of the fifth metatarsal with limited blood supply, making them harder to heal. These can be stress fractures (developing over time) or sudden breaks, often caused by repetitive stress, overuse, or trauma. Other fracture types, like midshaft fractures (from twisting or trauma) and fractures of the metatarsal head and neck, can also occur in this bone.

$Fifth metatarsal fracture locations$

Symptoms of a Fifth Metatarsal Fracture
Common symptoms of avulsion and Jones fractures include:

Pain, swelling, and tenderness on the outer foot
Difficulty walking
Bruising

Diagnosis of a Fifth Metatarsal Fracture
Anyone experiencing symptoms of a fifth metatarsal fracture should consult a foot and ankle surgeon promptly. The surgeon will ask about the injury’s cause, examine the foot, and may press on different areas to locate pain points. X-rays are typically used for diagnosis, though Jones fractures may require additional imaging as they can sometimes be hard to detect initially.

Nonsurgical Treatment
Until seeing a foot and ankle surgeon, follow the RICE protocol:

Rest: Avoid weight on the injured foot.
Ice: Apply an ice pack for 20 minutes with a towel barrier, then wait 40 minutes before reapplying.
Compression: Use an elastic bandage to help control swelling.
Elevation: Keep the foot raised above heart level to reduce swelling.

Nonsurgical treatment options include:

Immobilization: Depending on injury severity, a cast, boot, or stiff-soled shoe may be used, and crutches may help keep weight off the foot.
Bone Stimulation: For certain fractures, particularly Jones fractures, a bone stimulator may be used to encourage faster healing, especially if immobilization alone isn’t sufficient.

When Is Surgery Needed?
Surgery may be necessary if the bone is displaced, there are multiple fractures, or healing has not progressed adequately. A foot and ankle surgeon will select the most appropriate procedure based on individual needs.