Base of the Fifth Metatarsal Fracture
What is it: A fracture of the proximal portion of the fifth metatarsal.
How does it present: A patient will usually present with acute onset of pain after some trauma or twisting injury of the foot. They may have swelling and bruising over the area.
Common exam findings: Exam usually will show tenderness over the fracture site, bruising and swelling may be present. The patient may have difficulty with ambulating.
Tests and treatment: Diagnosis is generally made by x-ray of the foot. Treatment depends on where in the proximal fifth metatarsal the fracture is. If the fracture involves only the styloid region and is not significantly displaced, treatment may include a stiff soled shoe or immobilization in a cast for four to six weeks. Fractures that involve the metaphyseal-diaphyseal junction are called Jones' fractures. These take much longer to heal and are usually casted for eight to ten weeks in a non-weight bearing cast. Surgical intervention is sometimes indicated for some patients with a Jones fracture, so orthopedic consultation should be considered.