- Discussion:
- the most common frx of the base of the 5th metatarsal (over 90%);
- may be due to pull of the lateral cord of the plantar aponeurosis
- most often this frx is extra-articular, w/ the frx lying proximal to the
metatarsocuboid joint;
- commonly seen in dancers;
- frx may be associated w/
lateral malleolar frx;
- Radiographs:
- frx lines tend to be oriented more transversely to the joint;
- evidence of fracture healing lags behind radiographic union;
- Diff Dx:
-
Jones fracture:
-
Normal Apophysis:
- usually present between the ages of 9 to 14 years;
- apophyseal line runs parallel to shaft of metatarsal along its lateral-
inferior margin of the tubercle;
- it does not extend proximally into the joint;
-
Os peroneum:
- ossicle in
peroneus longus tendon where it is seen at the tip
of the fifth metatarsal base;
- is seen in 15% of population;
- Non Operative Treatment:
- short leg wt bearing cast for 4-6 wks;
- controversies:
- some authors advocate by a hard sole cast shoe and some (Wiener et al 1997) advocate a soft dressing;
- even if there is radiographic evidence of delayed union or non-union, the patient's
symptoms are usually minimal;
- Operative Treatment:
- indicated only for displaced or very large avulsion frx, which extend into the
cuboid-metatarsal joints;
Fractures of the fifth metatarsal. Analysis of a fracture registry.
Treatment of fractures of the fifth metatarsal: a prospective study.
Wiener BD.
Linder JF.
Giattini JF.
Foot Ankle Int.
18(5):267-9, 1997 May.
