![]() If radiography reveals a normal position seven to 10 days after injury, progressive weight bearing may be started, and the cast may be removed three to four weeks later.įractures of a single metatarsal with lateral or medial displacement usually heal well without correction and may be managed like nondisplaced fractures. Nondisplaced fractures of the proximal portion of metatarsals 1 through 4 can be managed acutely with a posterior splint followed by a molded, non–weight-bearing, short leg cast. Treatment of fractures distal to the tuberosity should be individualized based on the characteristics of the fracture and patient preference. Radiographs should be carefully examined to distinguish these fractures from tuberosity fractures. Proximal fifth metatarsal fractures that are distal to the tuberosity have a poorer prognosis. Avulsion fractures of the proximal fifth metatarsal tuberosity can usually be managed with a soft dressing. Stress fractures of the first to fourth metatarsal shafts typically heal well with rest alone and usually do not require immobilization. Nondisplaced fractures of the metatarsal shaft usually require only a soft dressing followed by a firm, supportive shoe and progressive weight bearing. Injuries to this ligament require referral or specific treatment based on severity. If the midfoot is injured, care should be taken to evaluate the Lisfranc ligament. Referral is generally indicated for intra-articular or displaced metatarsal fractures, as well as most fractures that involve the first metatarsal or multiple metatarsals. The fracture should then be characterized and treatment initiated. Initial evaluation should focus on identifying any conditions that require emergent referral, such as neurovascular compromise and open fractures. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.Patients with metatarsal fractures often present to primary care settings. If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. Bone stimulation, most commonly used for Jones fractures, may be used as part of the treatment or following an inadequate response to immobilization. A pain-free external device is used to speed the healing of some fractures. Crutches may also be needed to avoid placing weight on the injured foot. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot or stiff-soled shoe. The foot and ankle surgeon may use one of these nonsurgical options for treatment of a fifth metatarsal fracture: Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.Compression: An elastic wrap should be used to control swelling.Use ice for 20 minutes and then wait at least 40 minutes before icing again. Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin.Until you are able to see a foot and ankle surgeon, the RICE method of care should be performed: Because a Jones fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed. The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain. To arrive at a diagnosis, the surgeon will ask how the injury occurred or when the pain started. Pain, swelling and tenderness on the outside of the footĪnyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle surgeon as soon as possible for proper diagnosis and treatment.Examples include midshaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.Īvulsion and Jones fractures have the same signs and symptoms. Other types of fractures can occur in the fifth metatarsal. They are less common and more difficult to treat than avulsion fractures. Jones fractures are caused by overuse, repetitive stress or trauma. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. Avulsion fractures are often overlooked when they occur with an ankle sprain. This type of fracture is the result of an injury in which the ankle rolls. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. Two types of fractures that often occur in the fifth metatarsal are: ![]() The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe. Fractures of the Fifth Metatarsal What Is a Fifth Metatarsal Fracture?įifth metatarsal fractures (breaks) are common foot foot injuries. Please enable Javascript in your browser. Javascript is required to view the content on this page. ![]()
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