What is a fifth metatarsal fracture?
A Fracture of the fifth metatarsal is a common injury in which the bone responsible for connecting the ankle to the pinky toe breaks. Since the fifth metatarsal in the foot is used to connect the ankle to the pinky toe, it’s found on the very outer edge of the foot. The location of the fifth metatarsal makes it especially vulnerable to injury.
What are the types of fifth metatarsal fractures?
There are three different types of fractures that can occur as they relate to the fifth metatarsal.
Zone 1, Avulsion Fracture: These fractures account for the majority (up to 93%) of all fractures of the fifth metatarsal. In this type of fracture, a small bone fragment is pulled from the bone by a tendon or ligament and is typically the result of an injury causing an ankle sprain or roll. These fractures can fall to the wayside when they occur in this manner.
Zone 2, Jones Fracture: These fractures occur in a very particular are of the fifth metatarsal that biologically receives less blood flow that the other parts of the bone. Due to this lack of blood flow, this type of fracture may incur difficulties healing. This type of fracture can either be a stress fracture, which is a small, hairline break that occurs over a span of time, or an acute/sudden break. These fractures are commonly the result of overuse injuries, repetitive stress or trauma, and are less common, yet more difficult to treat than a Zone 1/Avulsion fracture.
Zone 3, Mid-Shaft Fracture or Dancer’s Fracture: This type of fracture traditionally is a result of twisting or trauma and occur at the head or neck of the metatarsal.
What causes a fifth metatarsal fracture?
A small percentage of fractures seen by physicians are found in the metatarsals, however, anyone can experience a fifth metatarsal fracture. Typically, men in their 30s and women in their 70s tend to see more of these fractures to the fifth metatarsal. Historically, there’s a larger correlation with women having either a Zone 1 or Zone 3 fracture than men.
A fracture of the fifth metatarsal can be caused by following:
- Trauma to the foot because of a direct blow
- High arches forcing pressure onto the outside of the foot
- Repetitive overuse of the affected foot
- Rolling of the ankle, specifically inward
- An injury involving the rotating or twisting of the foot due to accident or sports injury
What are symptoms of a fifth metatarsal fracture?
Be on the lookout for the following symptoms if you suspect you’ve fractured the fifth metatarsal in your foot:
- Bruising on the outer part of the foot
- Pain or discomfort in the affected foot
- Swelling or tenderness as it relates to the outside edge of the foot
How is a fifth metatarsal fracture diagnosed and treated?
If your healthcare provider suspects a fracture of the fifth metatarsal, they may order an X-ray, CT scan or MRI to confirm their suspicions and accurately locate the fracture.
A treatment plan will largely depend on the severity of the fracture, as well as several other factors including the patient’s age, activity level and their overall health. Immobilization with a cast or boot is the most used method to align and support the fifth metatarsal as it heals.
In more severe cases, your doctor may recommend a surgical procedure to correct misaligned bone fragments with a screw, rod, or other hardware. In the most extreme cases where the area of the fifth metatarsal is damaged beyond repair, your doctor may need to do a bone graft or recommend a bone stimulator to replace the damaged bone.
Recovery from a fractured fifth metatarsal is approximately 6-8 weeks but will vary by patient.
How can you prevent a fifth metatarsal fracture?
Not all accidents can be prevented, however, there are a few ways to do your part in working to prevent a fracture of the fifth metatarsal in your foot. Maintaining a healthy weight and managing chronic illness such as diabetes can have a direct impact on the overall health of the feet.