A break at the base of the 5th metatarsal, which is along the outside of your foot, is called a Jones fracture and could warrant surgical intervention to prevent the development of additional orthopaedic issues. Elton and his expert foot and ankle team may recommend the following conservative treatment methods:Ĭertain metatarsal fractures can require surgery. At his practice in Vail-Summit Orthopaedics & Neurosurgery, Dr. The majority of broken metatarsal bones can be treated nonsurgically. Pain at the site of the fracture when touchedĪlthough some fractures are more severe than others, one should never “push through the pain.” Even the most minor metatarsal fractures require treatment to heal correctly and avoid further complications. On the other hand, symptoms of metatarsal stress fractures include: Swelling and bruising that appears the following day Pain at the place of the fracture that will linger and sometimes disappear For example, in an acute fracture, the patient often reports: Symptoms for acute and stress fractures are different. Stress fractures in the metatarsal are often found in runners who increase their running mileage too quickly. These fractures can be acute, caused by a direct impact or blow to the foot, or stress fractures. Non-displaced: The bone has broken in a way that the bone has changed position, and the fragments are misaligned. Like all fractures, metatarsal fractures can be divided into two categories:ĭisplaced: The broken bone fragments are aligned with each other. The metatarsal bones are the long bones in the midfoot that connects the hindfoot to the phalanges. There are tendons, muscles, soft tissue, and 28 bones, 19 of which are toe bones or phalanges. Nondisplaced or minimally displaced (less than 2 mm) fractures of the lesser toes with less than 25% joint involvement and no angulation or rotation can be managed conservatively with buddy taping or a rigid-sole shoe.The foot is a complex structure. The Ottawa Ankle and Foot Rules should be used to help determine whether radiography is needed when evaluating patients with suspected fractures of the proximal fifth metatarsal.Įarly surgical management of a Jones fracture allows for an earlier return to activity than nonsurgical management and should be strongly considered for athletes or other highly active persons. Nondisplaced or minimally displaced (less than 3 mm) fractures of the second to fifth metatarsal shafts with less than 10° of angulation can be treated conservatively with a short leg walking boot, cast shoe, or elastic bandage, with progressive weight bearing as tolerated. The use of musculoskeletal ultrasonography may be considered to diagnose subtle metatarsal fractures.
Lesser toe fractures can be treated with buddy taping and a rigid-sole shoe for four to six weeks. Great toe fractures are treated with a short leg walking boot or cast with toe plate for two to three weeks, then a rigid-sole shoe for an additional three to four weeks. A Jones fracture has a higher risk of nonunion and requires at least six to eight weeks in a short leg non–weight-bearing cast healing time can be as long as 10 to 12 weeks. A fifth metatarsal tuberosity avulsion fracture can be treated acutely with a compressive dressing, then the patient can be transitioned to a short leg walking boot for two weeks, with progressive mobility as tolerated after initial immobilization. Proximal fifth metatarsal fractures have different treatments depending on the location of the fracture. Metatarsal shaft fractures are initially treated with a posterior splint and avoidance of weight-bearing activities subsequent treatment consists of a short leg walking cast or boot for four to six weeks. Management is determined by the location of the fracture and its effect on balance and weight bearing. Diagnosis requires radiographic evaluation, although emerging evidence demonstrates that ultrasonography may be just as accurate. Patients typically present with varying signs and symptoms, the most common being pain and trouble with ambulation. They most often involve the metatarsals and toes. Foot fractures are among the most common foot injuries evaluated by primary care physicians.
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