The second, third and fourth metatarsals are slender and may be sites of stress fracture or acute fractures from twisting mechanisms or a direct blow. The first metatarsal is larger than the others and most important for weight-bearing and balance therefore, malunion or malalignment at this location is especially poorly tolerated. There are no interconnecting ligaments between the 1st and 2nd metatarsals, allowing for independent motion. The medial three rays act as a rigid lever to aid in propulsion while the lateral two rays provide some mobility in the sagittal plane to permit accommodation to uneven ground. As a unit, the five metatarsals serve as the major weight-bearing complex of the forefoot. The bases of each metatarsal also articulate with each other at the intermetatarsal joints. The base of each metatarsal articulates with one or more of the tarsal bones and the head articulates with the proximal phalanges. They are numbered from 1 to 5, medial to lateral or largest to smallest (Figure 1). The metatarsals are dorsally convex tubular bones of the forefoot consisting of a head, neck, shaft, and base. The metatarsals are also subject to stress fractures and can be seen in conjunction with other injuries of the mid-foot. However, metatarsal fractures that go on to malunion or nonunion can lead to disabling metatarsalgia or midfoot arthritis. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.Metatarsal fractures are common injuries to the foot often sustained with direct blows or twisting forces. Many of these fractures are easy to treat and have a favorable prognosis. 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 nonsurgical 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 RICE 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 midshaft 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. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. 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. 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: The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe. Fractures of the Fifth Metatarsal What Is a Fifth Metatarsal Fracture?įifth metatarsal fractures (breaks) are common foot foot injuries. Please enable Javascript in your browser. Javascript is required to view the content on this page.
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