June 20, 2024

Fifth Metatarsal Fracture encompasses 68% of all metatarsal fractures, which is the most common metatarsal fracture.

By indirect force by base attachment of 3 muscles:

  1. Peroneus Brevis
  2. Peroneus Tertius
  3. Abductor digiti quinti
Anatomy of fifth metatarsal

Three types

Type 1

Pseudo-jones fracture

  • Cancellous tuberosity (93%)
  • The more common type is avulsion of the tip of the base, due to peroneus brevis tendon, and in this fracture articular surface may be involved
  • Due to sudden inversion force applied to the foot

Type 2

Jones fracture

  • Metaphysis fracture
  • Jones fracture
  • Sudden adduction force being to the foot resulting in tensile force being created along the lateral aspect of the metatarsal

Type 3

  • Distal to proximal ligaments
  • The fracture occurs at the dia-metaphyseal junction
  • Stress fracture zone
  • Represent the true stress fracture (high-performance athletes)

Dancer fracture: Spiral fracture of the shaft of the 5th metacarpal (absence of direct blow)

Treatment Options

Zone I

Non displaced: Conservative by below knee plaster cast (3-4 weeks)

Followed by elastic bandage support for another 3-4 weeks

Surgical treatment is indicated in

  • Communited
  • Displaced > 2 mm or involvement more than 30 % Cubo-metatarsal joint :- ORIF with TBW/ Small fragment screw

Zone II

Conservative treatment is tried

Fails=> Operative

Zone III

True stress fracture

Surgical treatment is done for established non-union

See also: Lisfranc Injury

See also: Hallux Valgus