Foot Fracture: Fifth Metatarsal Fracture

What is a fifth metatarsal fracture?

The metatarsals are the long bones of the feet. A fifth metatarsal fracture is a break in the foot bone that connects to the little toe. Sometimes there may be a break in several places.

What is the cause?

A fifth metatarsal fracture can happen several ways. It may happen when the foot or ankle rolls in or from a violent twist of the foot. It can also happen when a heavy object lands on the foot. Another type of fracture called a Jones fracture is a stress fracture caused by overuse--the bone gradually wears out and breaks.

What are the symptoms?

Symptoms may include:

• pain, swelling, or tenderness on the outer side of the foot
• trouble walking

How is it diagnosed?

Your provider will ask about your symptoms and how the injury happened. He or she will examine you. You will have X-rays of the foot. Sometimes a special test called a bone scan may need to be done to check for a stress fracture.

How is it treated?

The treatment depends on the type of fracture you have. You may need to have a cast or wear a stiff-soled shoe or removable cast boot for several weeks. If you have a Jones fracture, you may need to have surgery. You will usually need to use crutches until you can walk without pain.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the injured leg up on pillows when you sit or lie down.
  • Take pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• If you have a cast, make sure the cast does not get wet. Cover the cast with plastic when you bathe. Avoid scratching the skin around the cast or poking things down the cast. This could cause an infection.
• Use crutches or a cane as directed by your healthcare provider. Your provider will tell you how much weight you can put on your leg, if any.

Keep all appointments for provider visits or tests. Call your healthcare provider right away if:

• You have more pain, redness, warmth, or swelling.
• You have a fever higher than 101.5°F (38.6°C).
• Your foot looks pale or blue or feels cold.
• You have a loss of feeling in the injured area.

How long will the effects last?

Fifth metatarsal fractures usually heal within 6 weeks. Jones fractures may take longer to heal.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your foot recovers, not by how many days or weeks it has been since your injury has occurred. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may start rehabilitation exercises when your provider has taken a follow-up X-ray and see that your fracture has healed. You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:

• You have full range of motion in the injured foot compared to the uninjured foot.
• You have full strength of the injured foot compared to the uninjured foot.
• You can walk straight ahead without pain or limping.

How can I prevent a fifth metatarsal fracture?

Most fifth metatarsal fractures are caused by accidents that are not easy to prevent. However, shoes that fit well and give good support can help prevent injury. Also, try to avoid playing or running on surfaces that are uneven.