What is a fifth metatarsal fracture?
The metatarsals are the long bones of the feet. The fifth
metatarsal is the outermost foot bone and connects to the
little toe. A fracture is a break in a bone.
How does it occur?
A fifth metatarsal fracture can occur several ways and break
in several places.
- Avulsion fracture: This occurs when the foot or ankle
rolls in (an inversion injury). When this happens a
tendon that attaches a muscle to the fifth metatarsal can
pull off a piece of the bone.
- Mid-shaft fracture: This usually occurs from a violent
twist of the foot, but can also happen if a heavy object
lands on the foot.
- Jones fracture: This is a stress fracture caused from
overuse. Because of overactivity, the bone gradually
wears out and breaks.
What are the symptoms?
Pain, swelling, and tenderness on the outer side of the
foot. There will be difficulty walking.
How is it diagnosed?
Your provider will review your symptoms, ask how you injured
your foot, and examine you.
A fifth metatarsal fracture is diagnosed by an x-ray showing
a break in the bone. Some x-rays do not detect stress
fractures, and a special test called a bone scan may need to
be done.
How is it treated?
The treatment depends on the type of fracture you have.
There are several ways to treat each type of fracture.
- Avulsion fracture: This can be treated by wearing a
stiff-soled shoe or a removable cast boot for 4 to 6
weeks. You will usually be on crutches until you can
walk without pain.
- Mid-shaft fracture: This can be treated by wearing a
stiff-soled shoe, a removable cast boot, or a cast for 6
to 8 weeks. You will usually be on crutches until you
can walk without pain.
- Jones fracture: These fractures sometimes take a longer
time to heel. A stress fracture can be treated with a
removable cast boot or cast worn for 6 to 8 weeks. You
may need to have surgery and have a screw placed in your
bone to hold the broken bone together. You will usually
be on crutches until you walk without pain.
Treatment will also include:
- Elevating your foot by placing a pillow underneath it.
Try to keep your foot above the level of your heart.
- Taking an anti-inflammatory medication or other pain
medication prescribed by your provider.
If you are not in a cast, you should apply ice packs to your
foot for 20 to 30 minutes every 3 to 4 hours for the first 2
to 3 days or until the pain goes away. Thereafter, ice your
foot at least once a day until the other symptoms are gone.
When can I return to my sport or activity?
You may start your rehabilitation when your provider has
taken a follow-up x-ray and see that your fracture has
healed.
You may safely return to your sport or activity when,
starting from the top of the list and progressing to the
end, each of the following is true:
- You have full range of motion in the injured foot
compared to the uninjured foot.
- You have full strength of the injured foot compared to
the uninjured foot.
- You can jog straight ahead without pain or limping.
- You can spring straight ahead without pain or limping.
- You can do 45-degree cuts, first at half-speed, then at
full-speed.
- You can do 20-yard figures-of-eight, first at half-speed,
then at full-speed.
- You can do 90-degree cuts, first at half-speed, then at
full-speed.
- You can do 10-yard figures-of-eight first at half-speed,
then at full-speed.
- You can jump on both legs without pain and you can jump
on the injured leg without pain.
How can I prevent a fifth metatarsal fracture?
Most fifth metatarsal fractures are caused by accidents that
cannot be prevented. However it is important to wear proper
fitting footwear and avoid playing or running on surfaces
that are uneven.
Written Pierre Rouzier, MD.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2003 McKesson Health Solutions LLC. All rights reserved.