Fifth metatarsal fracture

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What is a fifth metatarsal fracture?

A fifth metatarsal fracture is a break in the bone on the outside of the foot. This bone is one of the metatarsal bones—the long bones in the middle of the foot that help you balance when you stand and walk. The fifth metatarsal is the bone most likely to break in the event of an acute injury to the foot. 

What causes a fifth metatarsal fracture?

Most acute fractures are the result of a sudden blow to, or severe twist of, your foot. The twisting mechanism pulls on the ligament that attaches to the base of the fifth metatarsal and pulls off a fragment of bone. Bones weakened from overuse or a medical condition such as osteoporosis are more susceptible to fracture.

What are the symptoms?

The most common symptoms of an acute fifth metatarsal fracture include pain, swelling and tenderness on the outside of the foot, as well as difficulty walking. In some cases, bruising may occur.

How is a fifth metatarsal fracture diagnosed?

If you have symptoms of a fracture, it’s important to consult a qualified foot and ankle surgeon as soon as possible. Your physician will examine your foot and take an X-ray to confirm the diagnosis. Occasionally, an MRI or CT scan is required to rule out other foot disorders.

What is the treatment?

Most fifth metatarsal fractures respond to conservative treatment, including rest, ice, non-steroidal anti-inflammatory drugs, immobilization in a shoe or boot, and activity modification. Healing typically occurs within six to eight weeks.

If these methods fail to bring relief, or if your injury involves multiple breaks or a displaced bone, surgery may be necessary. In this procedure, the physician realigns any part of the bone that has moved out of position and uses plates and screws to hold the bones in place as they heal.

Following surgery, most patients benefit from a course of physical therapy to restore strength and flexibility. Full healing and return to activities and sports usually takes three to four months.