Figure 2: Twisting mechanism causing injury The fracture commonly occurs in middle-aged or older women with low bone density (osteopenia or osteoporosis). Patients who have suffered a 5th metatarsal base avulsion fracture will give a history of a twisting injury to their ankle and foot (inversion plantarflexion injury), similar to what occurs with an ankle or foot sprain (Figure 2). This injury will be associated with quite specific local tenderness over the base of the bone, on the outside of the foot (the 5th metatarsal).
Base of fifth metatarsal fracture skin#
Over time, the skin can turn black and blue. Difficulty with balance due to weakness of the peroneus brevis also occurs. It can be associated with significant swelling. This will produce immediate pain over the outside aspect of the foot. Figure 1: 5th Metatarsal Avulsion FractureĪ patient who suffers an acute rolling of their ankle can also injure the base of the 5th metatarsal (See Figure 1). Some clinicians refer to this type of fracture as a “Dancer’s Fracture.” However, more commonly a “Dancer’s fracture” is considered a spiral fracture of the 5th metatarsal shaft that was originally described in Dancer’s. This type of injury needs to be differentiated from a “ Jones fracture“, which occurs slightly further towards the center of the 5th metatarsal. Impact activity, such as running may need to be deferred for up to 6 months for complete bone healing.
Base of fifth metatarsal fracture full#
It often takes 12 or more weeks for a full recovery to occur. It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level. In most instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing.
The major muscle that controls lateral foot balance, the peroneus brevis, also attaches at the base of the 5 th metatarsal and can be a source of increasing pain if not allowed to rest. A 5th metatarsal avulsion fracture causes localized pain, swelling, and difficulty walking.
During an avulsion injury, a variable size fragment of bone at the base of the 5th metatarsal is pulled off by a strong plantar ligament that is attached to this part of the bone. 5th Metatarsal Avulsion Fracture Summary 5th Metatarsal Avulsion Fracture HandoutĪ twisting injury to the ankle and foot may cause an avulsion (pulling off) fracture of the base of the 5th metatarsal – the bone that attaches the little toe to the midfoot (Figure 1).
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