The fifth metatarsal is the long bone in the middle of the foot that connects to the little toe joint. Fractures in the fifth metatarsal are common and often occur at the base of the bone.
Types of Fractures
There are two main types of fractures in the fifth metatarsal. The more common type is the avulsion fracture. This happens when the tissue of the base of the bone is suddenly pulled away, causing a piece of the bone to be chipped off. It is usually an injury caused by an explosive impact from jumping or a severe sprain of the ankle. Tennis players often incur this injury because of the nature of the sport that constantly requires changing directions. Thus, it is sometimes referred to as a “tennis fracture”.
Jones fracture is a hairline break at the base of the fifth metatarsal, slightly above the area of avulsion fracture. It is an overuse injury caused by repeated stress, but could also be caused by a sudden trauma. This injury is less common and because the part of the bone receives lesser blood, it is more difficult to heal. Recovery often takes longer than two months and chances of non-union are high.
Other types of fractures include stress fracture in the mid-shaft, metatarsal head and neck. These injuries usually occur in athletes as a result of twisting or trauma.
Both avulsion and Jones fractures have the same symptoms. Patients would experience pain, swelling and tenderness on the outside of the foot. Bruises may appear with the bleeding of the broken bones. It would be difficult to walk or bear weight on the foot and not recommended to do so as exertion might cause a further break in the bone.
Treatment should start as soon as the condition is diagnosed. For most cases, conservation method is used for treating fractures in the fifth metatarsal. However, because Jones fracture has a higher risk of non-union and refracture after it is healed, surgery might be a better option.
The RICE method (Rest, Ice, Compression, Elevation) should be immediately applied until you receive medical attention. When you get to the doctor’s, the foot is immobilized in a cast or boot with crutches to hold the weight off. Bone stimulation may be used to treat Jones fractures to speed up the healing process.
There are a few cases when surgery is required – the bone is significantly displaced or incurred multiple breaks, or when non-union occurs with conservative treatment. Internal fixation or bone grafting may be needed to surgically piece the bones back together.