Fractures of the
Fifth Metatarsal

Common Foot Problems

Fractures of the Fifth Metatarsal

The fifth metatarsal is the long bone on the outer foot that is attached to the pinky toe. This bone is a common site of fractures or breaks that often occurs as one of two types:

An avulsion fracture in which a small bone fragment is dislocated from the main part of the bone by a tendon or ligament. This type of fracture results in response to an injury when the ankle rolls. Avulsion fractures sometimes are not noticed when they result in conjunction with an ankle sprain.

A Jones fracture affects a small portion of the fifth metatarsal that receives less blood and therefore takes longer to heal. This type of fracture presents as either a stress fracture or an acute (sudden) break. A stress fracture is a tiny hairline break that develops over time. Contributing factors of Jones fractures are overuse, repetitive stress and trauma. Jones fractures are less common and less responsive to treatments than avulsion fractures.

There are other types of fractures found in the fifth metatarsal. These include mid-shaft fractures that are normally caused by twisting or trauma. Fractures of the metatarsal head and neck are also possible.

Avulsion and Jones fractures share the same signs and symptoms, including:

  • Sharp pain, swelling and tenderness on the outer foot.
  • Difficulty walking.
  • Possible bruising.

Individuals who experience symptoms of a fifth metatarsal fracture are strongly advised to immediately see Dr. Radovic for proper diagnosis and treatment. To diagnose this injury, Dr. Radovic will ask how the bone was injured, and when the pain started. 

Dr. Radovic will examine the foot by gently pressing on different areas to determine the location of pain. X-rays will be ordered to determine the extent of injury. A Jones fracture sometimes is not revealed on initial x-rays, so additional imaging studies may be necessary for diagnosis.

Patients are advised to follow the “R.I.C.E.” protocol until an appointment with Dr. Radovic can be made. This method of care is as follows:

  • Rest. Stay off of the affected foot. Undergoing activity can lead to further injury.
  • Ice. Apply ice to the injury by using a thin towel between the ice and the skin. Ice for 20 minutes, then allow the area to warm for at least 40 minutes before reapplying.
  • Compression. Use an elastic wrap to control swelling.
  • Elevation. Raise the foot at or slightly above heart level to reduce swelling.

Dr. Radovic may recommend one of the following conservative treatments for a fifth metatarsal fracture:

Immobilization: Methods may vary based on the severity of injury and can include a cast, a cast boot or stiff-soled shoe. Crutches may also be used to relieve weight from the affected foot.

Bone stimulation: A pain-free external machine is used to accelerate the healing of select fractures. Bone stimulation is most often used for Jones fractures and may be included as a treatment if patients do not show improvement from immobilization.

Surgery may be necessary in the presence of a displaced bone, multiple breaks or inadequate healing after injury. Dr. Radovic will choose the most suitable procedure for each individual patient.

To learn about Fifth Metatarsal Surgery 

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