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:
- Peroneus Brevis
- Peroneus Tertius
- Abductor digiti quinti
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
