Outer Foot Bone Fractures (5th Metatarsal Fractures): Treatment Options

Outer Foot Bone Fractures (5th Metatarsal Fractures): Treatment Options

This video will discuss treatment options for 5th metatarsal fractures, or breaks, in the most outer foot bone. The 5th metatarsal is one of the most frequently fractured bones in the foot, specifically the base of this bone being the most common area to be injured.

It is important to note that treatment recommendations for these fractures vary. They will be made based on the exact location of the fracture and specific patient considerations such as activity level and general health. The location of the fracture at the base of this bone helps determine treatment recommendations.

Zone 1 fractures are the most common area to be injured and are often the result of an inversion injury. An inversion injury occurs when the foot rolls inward and the ankle turns outward. These fractures have excellent healing potential.

Zone 2 fractures, or Jones fractures, can be seen in highly active individuals with acute injuries. Given the poor blood supply in this area, these fractures are at higher risk of having delayed or incomplete healing.

Zone 3 fractures can be seen in the setting of repetitive stress to the outside of the foot, such as in athletes. They can also be the result of metabolic abnormalities or foot deformities such as a high arch. These fractures may also have the risk of delayed or incomplete healing.

Nonoperative treatments for these fractures may be considered in the following circumstances. Zone 1 fractures that are minimally displaced. Treatment will consist of protected weight-bearing with some form of immobilization, such as a stiff-soled shoe or boot.

Zone 2 and 3 fractures may be treated nonoperatively, although they may be prone to slow or incomplete healing if treated in this manner. If nonoperative treatment is chosen, the patient will be kept non-weight-bearing for several weeks.

In either circumstance, the patient will be seen in close follow-up for x-rays and assessment of symptoms. Physical therapy may be ordered to help restore function and strength.

Generally, surgical treatment is indicated for fractures that have significant displacement, those in highly active patients, such as athletes, fractures with delayed or incomplete healing, and fractures due to foot deformities.

If surgery is chosen, there are many implants that may be used. Specifically for zone 2, or Jones fractures, screws are the most common. Postoperative recommendations may vary considering the type of surgery chosen and the general health of the patient.

One should expect a short period in which they will be non-weight-bearing following surgery. In follow-up visits, a health care provider will review x-rays and symptoms to determine weight-bearing status and physical therapy needs, so the patient can have a return to full activity.