Surgery is common for theseįractures due to the risk for delayed healing or reinjury. They also are at risk of refracture even after healing. These fractures are known to have a higher chance of not healing (nonunion). They occur at the intersection between the base and the shaft of the fifth metatarsal. Zone 2 fractures are known as Jones fractures.These fractures typically are treated without surgery using a cast, boot, or hard-soled shoe and tend to heal within 6-8 weeks. Zone 1 fractures are avulsion or chip fractures that occur at the tip of the base of the fifth metatarsal.The total recovery time before complete unrestricted activities may be resumed is often 6 months or more.The base of the fifth metatarsal is divided into three fracture zones. Once this has been done, the typical recovery again involves a period of immobilization in a cast, boot, or stiff sole shoes for 6 or more weeks, allowing for appropriate healing. In rare instances, it may be necessary to open up the fracture and fix it with screws or a small plate in order to stabilize it in an improved position. In this instance, the fracture may be manipulated back into place and stabilized with a wire (pin). Occasionally the fracture will be markedly displaced and surgery will be required.
Once this has been done, typical non-operative treatment of immobilization and crutches non-weight bearing, or heel walking is instituted. A manipulation involves moving the bone into an improved position and may be done under local anesthetic. Whether there is excessive displacement of the fracture is usually determined by the surgeon, based on the clinical examination and the x-ray findings. If the bone is going to heal in a flexed position, or if allowing it to heal in its present position will cause a permanent lump on the bottom, top, or side of the foot, then manipulating it back into a better position is indicated. If the bone is sufficiently out of position, it will need to be manipulated into a better position.
5TH METATARSAL FRACTURE FULL
Full recovery of function often takes many months. Crutches non-weight bearing or heel walking may prevent further displacement. Relative immobilization in a stiff sole shoe or walker boot for 6-8 weeks is usually adequate. If the fracture is not displaced or only minimally displaced, it may be treated with rest and immobilization to allow healing. Treatment of 5th metatarsal neck fractures is usually non-operative. This will allow the physician to determine if the fracture is displaced, and whether the fracture position is acceptable to allow non-surgical treatment. X-ray of the foot will reveal the fracture. There may be some sensation of numbness or tingling in the 5th toe.
5TH METATARSAL FRACTURE SKIN
If the fracture is displaced, the bone (5th Metatarsal head) may be prominent, creating a lump against the skin either on the top, bottom, or outside of the foot. Physical examination will identify swelling of the outside part of the forefoot. Typically the injury will occur from a direct blow, such as dropping an object on the foot, or from jamming the outside of the foot against a solid object, often with an associated twisting motion. Symptoms will include pain, swelling, and great difficulty walking. Clinical PresentationĪn acute injury to the outside part of the front of the foot (base of the little toe) may lead to a 5th metatarsal neck fracture. Occasionally the fracture will need to be repositioned so that it heals in an appropriate position. Treatment is usually non-operative in a walker boot, with limited mobilization through the heel or non-weight bearing on crutches. They occur following an acute injury, often from jamming the foot against a solid object. 5th metatarsal neck fractures result in pain and swelling on the outside part of the forefoot.