(See also Overview of Fractures Overview of Fractures A fracture is a break in a bone. Most fractures result from a single, significant force applied to normal bone. In addition to fractures, musculoskeletal injuries include Joint dislocations... read more .)
Pain, swelling, and tenderness are usually well-localized to the fracture site.
Diagnosis of fractures of the 5th metatarsal is based on anteroposterior, lateral, and oblique foot x-rays.
Fractures of the 5th metatarsal diaphysis
Fractures of the 5th metatarsal diaphysis can be acute fractures or stress fractures Stress Fractures Stress fractures are small incomplete fractures that often involve the metatarsal shafts. They are caused by repetitive weight-bearing stress. Stress fractures do not usually result from a discrete... read more . Acute diaphyseal fractures tend to occur near the metaphysis and are sometimes called Jones fractures.
Because the blood supply may be disrupted, nonunion and delayed union can result.
Treatment of Fractures of the 5th Metatarsal Bone
Casting with no weight bearing
Treatment of 5th metatarsal diaphyseal fractures involves a 3-sided short leg cast with no weight bearing for 6 weeks; patients are referred to an orthopedic surgeon to determine whether open reduction with internal fixation (ORIF) should be done.
Fractures of the 5th metatarsal base
Fractures of the base are sometimes called dancer's or pseudo-Jones fractures. The mechanism is usually a crush injury or an inversion force that causes avulsion by the peroneus brevis tendon. These fractures are more common than acute diaphyseal fractures (Jones fractures).
Because the base, unlike the diaphysis, has abundant collateral circulation, delayed union and nonunion are rare.
Treatment of 5th metatarsal base fractures is symptomatic and may include a hard-soled shoe or walking boot and weight bearing as tolerated.