5th Metatarsal Fractures: Treatment & Symptoms
What is a Fifth Metatarsal Fracture?
The fifth metatarsal is the long bone on the outer side of the foot connecting to the little toe. Fractures in this bone are common and can occur in various locations along it. Injuries from foot or ankle trauma, including stress fractures, can lead to a crack or break in the fifth metatarsal. The exact location and severity of the fracture are crucial for determining treatment, and imaging, like X-rays, is often needed for a precise diagnosis.
Both ankle injuries and repeated trauma can lead to fractures in the fifth metatarsal, making it vulnerable to stress fractures as well.
Avulsion Fractures
An avulsion fracture happens near the end of the fifth metatarsal, close to the ankle, where the bone attaches to a tendon. This type of fracture typically occurs from an ankle roll or sprain. Treatment often includes rest, ice, crutches, a cast, or a walking boot, with surgery rarely needed to secure the bone.
Jones Fractures
Jones fractures occur further along the bone, away from the ankle. These are often seen in athletes and can result from high-impact activities, repetitive stress, or increased foot strain due to weight gain. This area has a limited blood supply, leading to a longer healing process. Surgical treatment may be an option for athletes to speed up recovery.
Fifth Metatarsal Shaft Fractures
Fractures in the shaft of the fifth metatarsal, also known as "dancer’s fractures," often appear severe on X-rays but are generally treated without surgery.
Symptoms of a Fifth Metatarsal Fracture
Symptoms typically appear on the outside of the foot and may include:
- Pain
- Difficulty walking
- Bruising
- Swelling
- Tenderness
These symptoms are consistent across fracture types, though the location of the pain may indicate the specific fracture type.
How is a Fifth Metatarsal Fracture Diagnosed?
Doctors will ask about recent injuries and pain history, followed by a physical examination to locate the fracture. Imaging may be ordered for further assessment.
- X-ray: Often used to identify the type and location of a fifth metatarsal fracture, though Jones fractures may not always show clearly.
- CT or MRI: May be needed for Jones fractures to get a more detailed view.
Treatment for Fifth Metatarsal Fractures
Treatment depends on the fracture type and severity. Some fractures may heal with nonsurgical methods, while others require surgery. Factors like age, activity level, and health also influence treatment choices.
Immobilization
After an injury, the RICE method (rest, ice, compression, and elevation) is advised until medical evaluation. Immobilization, often used for avulsion fractures and sometimes for Jones fractures, involves stabilizing the foot in a cast or boot, often for six to eight weeks, with crutches to avoid weight-bearing.
Bone Stimulation
In some cases, a bone stimulator may be used to enhance healing. This external device encourages bone growth, especially beneficial for Jones fractures but applicable for other types as well.
When is Surgery Necessary for a Fifth Metatarsal Fracture?
Surgery may be recommended for displaced bones or multiple breaks. Elite athletes may also opt for surgery. It’s often used for mid-shaft or Jones fractures if other treatments, like immobilization, don’t succeed. Surgery involves inserting a pin, screw, rod, or plate to hold the bone in place.
Healing Time for a Fifth Metatarsal Fracture
Healing typically takes six to eight weeks, whether through immobilization or surgery, with limited weight-bearing for six weeks post-surgery. Physical therapy can aid in regaining foot and ankle mobility, and a full return to sports usually occurs in three to four months.
