Type II: nonweight-bearing immobilization vs. Type I: nonweight-bearing immobilization for six to eight weeks (may require up to 20 weeks) Stress fracture of the proximal metatarsal within 1.5 cm of tuberosity Types II, III: variable healing potential surgical fixation for active athletes or patients preferring surgical therapy Type II: nonweight-bearing immobilization vs. As one of the most common fractures of the foot, the blood supply characteristics and unique anatomy of proximal fifth metatarsal fracture makes a high risk of delayed union or non-union of fractures occurring at the junction of the diaphyseal-metaphyseal. Type I: nonweight-bearing immobilization for six to eight weeks Diagnosis is made with plain radiographs of the foot. Laterally directed force on forefoot with ankle in plantar flexion SUMMARY 5th Metatarsal Base Fractures are among the most common fractures of the foot and are predisposed to poor healing due to the limited blood supply to the specific areas of the 5th metatarsal base. Although most fractures of the proximal portion of the fifth metatarsal respond well to appropriate management, delayed union, muscle atrophy and chronic pain may be long-term complications.Īcute fracture of the proximal metatarsal within 1.5 cm of tuberosity (Jones fracture) Care should be taken in differentiating an avulsion. All displaced fractures and type III fractures should be managed surgically. Metatarsal fractures are common in the paediatric population and rarely require operative management. Type II fractures may also be treated conservatively or may be managed surgically, depending on patient preference and other factors. Type I fractures are generally treated conservatively with a nonweight-bearing short leg cast for six to eight weeks. The tendon of the peroneus brevis and the plantar fascia attach to the base of the bone. Management and prognosis of both acute (Jones fracture) and stress fracture of the fifth metatarsal within 1.5 cm of the tuberosity depend on the type of fracture, based on Torg's classification. It is the most commonly fractured metatarsal bone. Nondisplaced tuberosity fractures are usually treated conservatively, but orthopedic referral is indicated for fractures that are comminuted or displaced, fractures that involve more than 30 percent of the cubo-metatarsal articulation surface and fractures with delayed union. Local bruising, swelling and other injuries may be present. Tuberosity avulsion fractures cause pain and tenderness at the base of the fifth metatarsal and follow forced inversion during plantar flexion of the foot and ankle. Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity.
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