Base 5th Metatarsal Fracture

Injury Description:

These fractures can manifest in different ways:

• Avulsion Fracture: In an avulsion fracture, a small piece of bone is pulled away from the main metatarsal bone. This often occurs because of sudden twisting or excessive stress on the foot, such as during sports activities.

• Jones Fracture: A Jones fracture is a more serious and less common type of injury at the base of the fifth metatarsal. It typically occurs further down the metatarsal bone, closer to the middle of the foot. Jones fractures are often characterised by a transverse or diagonal break and are more prone to delayed healing or non-union.

Common Symptoms:

• Pain and tenderness at the outer edge of the foot.

• Swelling and bruising around the affected area.

• Difficulty bearing weight on the affected foot.

• In some cases, a visible deformity or abnormal positioning of the fifth metatarsal bone.

• Pain that worsens with activity or when walking.

The severity of the fracture can vary, from mild cases that may heal with conservative treatment like casting or bracing to more complex fractures that require surgical intervention.

Indications for Surgery:

• Surgery is typically considered when conservative treatments such as casting, bracing, or immobilisation fail to adequately heal the fracture, or if the fracture is unstable, displaced, or involves a Jones fracture. Surgery may also be recommended for athletes or individuals with high physical demands.

Surgical Options:

There are various surgical procedures to address fractures at the base of the fifth metatarsal. Common approaches include:

• Open Reduction and Internal Fixation (ORIF): The surgeon makes an incision to access the fracture, repositions the bone fragments, and uses screws, wires, or plates to stabilise the fracture.

• Intramedullary Screw Fixation: This procedure involves inserting a screw through the centre of the metatarsal bone to hold it in place.

• Bone Grafting: In some cases, bone grafts may be used to promote healing, especially for non-unions (when the fracture fails to heal).

Recovery Time:

• Recovery time varies depending on the severity of the fracture and the surgical approach used. It typically involves a period of non-weight-bearing on the affected foot followed by gradual weight-bearing and physical therapy. Your surgeon will provide a specific timeline for your recovery.

Potential Risks and Complications:

• As with any surgery, there are risks associated with surgery for fifth metatarsal fractures. These may include infection, hardware complications, delayed or non-union of the fracture, and nerve or blood vessel damage. Be sure to discuss these risks with your surgeon.

Post-Surgery Care:

• Follow your surgeon's post-operative instructions diligently. This may include keeping the foot elevated, using crutches, wearing a cast or protective boot, and adhering to weight-bearing restrictions.

Physical Therapy:

• Physical therapy is often a critical component of recovery. A physical therapist will guide you through exercises to regain strength, mobility, and function in your foot.

Long-Term Outlook:

• With proper treatment and rehabilitation, many people recover well from surgery for fifth metatarsal fractures. However, the outcome can vary, and it may take several months to return to full activity levels.

Consultation with a Specialist:

• Always consult with an orthopaedic surgeon with a special interest in foot and ankle conditions to discuss your specific case. We can assess your condition, recommend the most suitable treatment option, and provide personalised guidance throughout the recovery process.

Remember that this information is for general guidance only, and your treatment plan should be tailored to your unique circumstances. Be sure to discuss all your questions and concerns with your healthcare provider.