![]() ![]() The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient. 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 non-surgical 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 “ R.I.C.E.” 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 mid-shaft 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. You might develop it if you participate in activities that involve running and jumping. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Metatarsalgia (met-uh-tahr-SAL-juh) is a condition in which the ball of your foot becomes painful and inflamed. 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. Metatarsal fractures represent the most common injury of the foot, accounting for approximately 56 of all the fractures encountered in the primary care setting, with about 4570 of these injuries involving the fifth metatarsal ().Their incidence has been reported as high as 1. 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: It has a base (tuberosity) where the peroneus brevis tendon and lateral plantar. A vascular watershed area exists in zone 2, contributing to the high nonunion rates seen with these fractures.Ĭopyright © 2023, StatPearls Publishing LLC.Fractures (breaks) are common in the fifth metatarsal – the long bone on the outside of the foot that connects to the little toe. The 5th metatarsal bone is the long bone located on the outside of the foot. Metaphyseal arteries and diaphyseal nutrient arteries provide the blood supply to the fifth metatarsal base. Additionally, a patient may sustain a shaft fracture greater than 1.5 cm distal to the tuberosity, a long spiral fracture extending into the distal metaphyseal area, the so-called dancer's fracture, or a stress fracture of the metatarsal.Ĭlassification of these fractures is crucial to making management decisions. Fractures through zone 1 are called pseudo-Jones fractures, and fractures through zone 2 are referred to as Jones fractures. Nevertheless, it is critical that the clinician recognizes all injury patterns of the fifth metatarsal and initiate the appropriate treatment plan or referral process to avoid potential complications.Ĭlassified by Lawrence and Bottle, the base, or proximal aspect, of the fifth metatarsal is broken up into three anatomical zones: zone 1, the tuberosity zone 2, the metaphyseal-diaphyseal junction and zone 3, the diaphyseal area within 1.5 cm of the tuberosity. Since orthopedic surgeon Sir Robert Jones first described these fractures in 1902, there has been an abundance of literature focused on the proximal aspect of the fifth metacarpal due to its tendency towards poor bone healing. Fractures of the fifth metatarsal are common injuries that must be recognized and treated appropriately to avoid poor clinical outcomes for the patient.
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