FIFTH METATARSAL FRACTURE
WHAT IS IT?
Fifth metatarsal fractures (breaks) are common foot foot injuries. The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe. Two types of fractures that often occur in the fifth metatarsal are:
Avulsion fracture. In an avulsion fracture, a small piece of bone is pulled o the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are oen overlooked when they occur with an ankle sprain.
Jones fracture. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress or trauma. They are less common and more difficult to treat than avulsion fractures. Other types of fractures can occur in the fifth metatarsal. Examples include midsha fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.
SYMPTOMS
Avulsion and Jones fractures have the same signs and symptoms. These include:
- Pain, swelling and tenderness on the outside of the foot
- Difficulty walking
- Bruising
TREATMENT
Nonsurgical Treatment
Until you are able to see a foot and ankle surgeon, the RICE method of care should be performed:
- Rest: Stay o the injured foot. Walking may cause further injury.
- Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Compression: An elastic wrap should be used to control swelling.
- Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.
The foot and ankle surgeon may use one of these nonsurgical options for treatment of a fifth metatarsal fracture:
- Immobilization. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot or sti-soled shoe. Crutches may also be needed to avoid placing weight on the injured foot.
- Bone stimulation. A pain-free external device is used to speed the healing of some fractures. Bone stimulation, most commonly used for Jones fractures, may be used as part of the treatment or following an inadequate response to immobilization.
When Is Surgery Needed?
If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. The foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient.
WHAT ARE TREATMENTS FOR ACHILLES TENDINITIS?
Treatment approaches for Achilles tendinitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon. In the early stage, when there is sudden (acute) inflammation, one or more of the following options may be recommended:
- Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon and promote healing.
- Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the condition.
- Orthotics. For those with overpronation or gait abnormalities, custom orthotic devices may be prescribed.
- Night splints. Night splints help to maintain a stretch in the Achilles tendon during sleep.
- Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching and ultrasound therapy.
WHY CHOOSE A FOOT AND ANKLE SURGEON?
Foot and ankle surgeons are the leading experts in foot and ankle care today. As doctors of podiatric medicine – also known as podiatrists, DPMs or occasionally “foot and ankle doctors” – they are the board-certified surgical specialists of the podiatric profession. Foot and ankle surgeons have more education and training specific to the foot and ankle than any other healthcare provider.
Foot and ankle surgeons treat all conditions affecting the foot and ankle, from the simple to the complex, in patients of all ages including Haglund's deformity. Their intensive education and training qualify foot and ankle surgeons to perform a wide range of surgeries, including any surgery that may be indicated for Haglund's deformity.
