Printed from FootHealthFacts.org, the patient education website of the, A Winning Strategy: Don't Play Through Pain, Pain, swelling and tenderness on the outside of the foot. Falling 4. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient. UpToDate. These include: Anyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle surgeon as soon as possible for proper diagnosis and treatment. Second most common fracture at base of 5th metatarsal 2. The fifth metatarsal is the long bone that is located on the outside of the foot and connects to the small toe. [3, 9] Fractures are of 2 general types, the Jones fracture and the pseudo-Jones or tennis fracture… You have 5 metatarsals. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. Stuart Hershman, MD, is board-certified in orthopaedic surgery. These long thin bones are located between the toes and the ankle (between the tarsal bones in the hindfoot and the phalanges in the forefoot). This 5th metatarsal “Dancer’s” fracture causes localized pain, swelling, and difficulty walking. Read our, Medically reviewed by Stuart Hershman, MD, Medically reviewed by Jonathan Cluett, MD, Learn What Physical Therapy Can Be Done After a Jones Fracture, Stress Fracture: Causes, Treatment, Prevention, Anatomy and Common Injuries of the Feet or Ankles, Avulsion Fracture of the Fifth Metatarsal, Joe Biden Foot Hairline Fracture: What It Is and How It's Treated, These Are the Most Common Fractures of the Leg, Ankle, and Foot. Zone I fractures occur through the tuberosity and are considered avulsion injuries. Some fractures may be predisposed to poor healing due to the limited blood supply to the specific areas of the 5th metatarsal … Nondisplaced tuberosity avulsion fractures can be treated non-operatively. Fractures here often occur when the toes are on the ground, the heel is off the ground and there is a change in direction of the foot, resulting in the patient’s weight shifting over the fifth metatarsal. Two types of fractures that often occur in the fifth metatarsal are: 1. In general terms fractures of the fifth metatarsal can occur at three sites. Dr. said it is going to heal, saw the last x-ray a month ago and there is still a big gap at the outer end of the bone. Avulsion fracture of the 5 th metatarsal styloid, also known as a pseudo-Jones fracture or a dancer fracture, is one of the more common foot avulsion injuries and accounts for over 90% of fractures of the base of the 5 th metatarsal.. This bone can be susceptible to breaks, particularly for very active people. Proximal fifth metatarsal fractures are common injuries that can arise in the athletic as well as the non-athletic population. To arrive at a diagnosis, the surgeon will ask how the injury occurred or when the pain started. Dancer’s Fractures (Avulsion fracture of the base of the 5th metatarsal) Avulsion fractures occur at the base of the fifth metatarsal, in Zone 1 where the peroneus brevis and plantar fascia insert (Figure 4). These fractures occur during forced inversion of the foot and ankle while plantar flexed. 2013;35(4):287-92. doi:10.1097/TME.0b013e3182aa057b. Founded in 1942, the American College of Foot and Ankle Surgeons is a specialty medical society of more than 7,800 foot and ankle surgeons. A metatarsal bone fracture is a complete or incomplete break in one of the five metatarsal bones in each foot. Jones fractures occur in the metatarsal bone just beyond the avulsion fractures. Dancing places more physical demand on the foot and ankle and increases their risk of injury. There are two types of fractures that often occur in the fifth metatarsal, avulsion fracture and Jones fracture. Another type of fracture which occurs on the fifth metatarsal is the avulsion fracture. Quill 1 reported a classification of fifth metatarsal base fractures based on 3 zones (Figure 36-1). Fifth Metatarsal Fractures Fractures of the fifth metatarsal are commonly encountered foot injuries. Jones fractures are more difficult to heal and often require immobilization (cast treatment), protection from weight (crutches), and may require surgery. This part of the fifth metatarsal bone is prone to injury. Timely treatment and rehabilitation are key to proper healing. If the fifth metatarsal base … Fractures (breaks) are common in the fifth metatarsal—the long bone on the outside of the foot that connects to the little toe. The proximal fifth metatarsal is the most common site of midfoot fractures. Dropping heavy objects onto the foot 3. Approximately one-third of metatarsal fractures involve the shaft or distal portion of the metatarsal. Avulsion fractures tend to heal easily, and seldom require surgical treatment. However, certain situations may require surgical treatment. This area of the bone has low blood flow. Avulsion fracture.In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. The 5th metatarsal is the outer bone that connects to your little toe. Healing time of a Jones fracture is typically 12 weeks. J Am Acad Orthop Surg. Abrupt onset of lateral foot pain, with no prior history of pain at that site, suggests acute injury and helps distinguish from stress injury 3. Fifth metatarsal fractures are generally the result of trauma to the foot, caused either by a direct blow or a rotational (twisting) injury. 5th metatarsal base fractures are among the most common fractures of the foot. Avulsion fractures tend to heal easily, and seldom require surgical treatment. Fifth metatarsal fractures are breaks in the fifth metatarsal bone, the bone that connects the little toe’s proximal phalanx — that is, the phalanx closest to the ankle — to the cuboid bone. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Occurs due to sudden change in direction with heel off the ground 4. The other metatarsal bones can also be broken. They are the middle bones in your feet, between your toes and your anklebones (tarsals). The Lisfranc joint is the point at which the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. Avulsion fractures, sometimes called a pseudo-Jones fracture, when the tip of the bone is pulled off the fifth metatarsal by the tendon that attaches to this region. Fractures of the Proximal Fifth Metatarsal: Selecting the Best Treatment Option. Full healing takes 6-8 weeks. Several radiographic findings may be confused with fractures of the fifth metatarsal. The proximal 5th metatarsal is the site of a number of fractures and variants which mimic fractures. These fractures are usually caused by: 1. Excluding toe fractures, metatarsal fractures are the most common foot fracture . Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. Healing time of a stress fracture also is typically at least 3 months. Accessory bones typically have smooth, rounded edges and a hint of cortex around their entire circumference, whereas fracture fragments usually have one jagged or straight edge that lacks cortication. 5th metatarsal fracture 5 months on by: Nicole Hi, I have a my 5th metatarsal fracture 1st week of June (fractured from the base) I am 45 yr old. The fifth metatarsal is the last bone at the outside of the foot, and most breaks of the fifth metatarsal occur at the base. Fifth metatarsal fracture (Jones fracture) rehab protocol. Usually, a stiff-soled shoe, such as a cast shoe, is worn for a few weeks until the pain and swelling have subsided. A fifth metatarsal fracture is a break located in the long, laterally located tubular bone of the forefoot that is attached to the small toe. 1995;3(2):110-114. A 5th metatarsal fracture is a relatively common condition characterized by a break in the long bone situated at the outer aspect of the foot known as the 5th metatarsal (figure 1). What Are the Causes of the Jones Fracture of the Foot? The fifth metatarsal is the bone on the outside of the midfoot at the base of the small toe. 2nd-5th metatarsal have distal intermetatarsal ligaments that maintain length and alignment with isolated fractures implicated in formation of interdigital (Morton's) neuromas multiple metatarsal fractures lose the stability of intermetatarsal ligaments leading to increased displacement Sometimes athletes can be their own worst enemy, especially when they continue to play following an injury to... What Is the Lisfranc Joint? The proximal end of the fifth metatarsal (proximal means closer to the center of the body) is easily felt as the bump over the outside part of the midfoot. These fractures often start with vague pain on the outside of the foot, often thought to be tendonitis. Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity. The two other common types of fractures are avulsion fractures and Jones fractures, which are associated with the fifth metatarsal. A fifth metatarsal fracture is a type of broken bone in your foot. Don’t ignore foot pain on the dance floor. Yet surgery is not always necessary. Figure 1 – Relevant Anatomy for a 5th Metatarsal Fracture. Stress fractures of the fifth metatarsal are the hardest to heal and are more likely to require surgery. A complete clinical and radiological assessment is required to select the best treatment option. Zone 2 is the traditional Jones fracture located at the junction between the proximal diaphysis and metaphysis of the fifth metatarsal without distal extension beyond the fourth to fifth intermetatarsal articulation. Fifth metatarsal fractures account for almost one quarter of all metatarsal injuries, and most occur at the base of the bone. The base of the fifth metatarsal is located on the outside (lateral) aspect of the foot where you can feel a prominent bone, about half way along the length of the foot. Proximal fifth metatarsal fractures. Unfortunately, this type of fracture is often overlooked because of the ankle injury. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. This type of fracture i… The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain. Until you are able to see a foot and ankle surgeon, the RICE method of care should be performed: The foot and ankle surgeon may use one of these nonsurgical options for treatment of a fifth metatarsal fracture: If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. Kicking a particularly hard objectMetatarsal fractures are particularly common in Soccer, which accounts for roughly three-in-four of all sport-related injuries of this type. In athletes, sometimes surgical treatment is considered even in acute settings, just to ensure the healing process is predictable. The majority of fifth metatarsal fractures are treated without surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. Jones fractures are caused by overuse, repetitive stress, or trauma. Stress fractures most commonly occur further down the bone. Or it can happen when a person jumps or changes direction quickly and twists his or her foot or ankle the wrong way. Most often these injuries can be treated similarly to a ligament or tendon injury. In adults, high forces are required to fracture the first metatarsal. It may be broken at various points along its length, depending on the mechanism of injury. Copyright © 2020 American College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. The 3 Types of Fifth Metatarsal Fractures, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The surgeon will also order x-rays. Thank you, {{form.email}}, for signing up. Patient will be walking with crutches non-weightbearing until most of the swelling resolves. The fifth metatarsal is the most commonly fractured of all the metatarsal bones.. Avulsion fractures, sometimes called a pseudo-Jones fracture, when the tip of the bone is pulled off the fifth metatarsal by the tendon that attaches to this region. Direct blows and twisting injuries cause many of these fractures. Fortunately, though, fractures of the fifth metatarsal rarely require surgery. The fifth metatarsal bone is the most common metatarsal bone to be fractured in sudden (acute) injury to the foot. If the injury is acute, meaning the diagnosis is made immediately following the injury, then non-surgical treatment is much more likely to be effective. This is a fracture which occurs with ankle sprains and occurs at the base of the fifth metatarsal. Plating options that includes low-profile fracture utility plates, 3 different 5th metatarsal fracture plates and a pinch plate designed to facilitate distal metatarsal osteotomies; Versatile, low-profile plate designs are Type II anodized, pairing increased strength* with minimal construct prominence