Fractures of the Watershed region (Jones Fracture) Avulsion Fractures (pseudo-Jones Fractures)įractures of the base of the metatarsal are often referred to as an avulsion fracture. Here, a small piece of bone is pulled off the metatarsal by a tendon or ligament/fascia during a twisting injury of the foot or ankle. This type of fracture is sometimes called a “pseudo-Jones” fracture. It is very important to distinguish this type of fracture from a Jones Fracture as their treatments and outcomes are quite different. Location specific diagnostic considerations:Īt OrthoArizona, we see three main types of fractures of the fifth metatarsal. At OrthoArizona, advanced imaging such as CT scans or MRI are usually only ordered to diagnose 5th metatarsal fractures when history and physical exam is suspicious for fracture but X-rays are negative. Physical exam and X-ray is usually all that is needed to diagnose a fifth metatarsal fracture. The main complaint seen in our patients is pain, swelling to the outer half of the foot, and associated bruising which can sometimes be seen in an acute injury. Patients also may have difficulty walking secondary to pain in the foot. Some people may experience some tingling or numbness into the lesser toes if they have a significant amount of swelling, but actual nerve injury is rare. What are the symptoms of a fifth metatarsal fracture? Patients will sometimes be seen to have excessive wear of their shoes on the outer portion of the sole because of the pressure put on that part of the foot and shoe. We see fifth metatarsal fractures in patients of all ages and activity levels but in our region they appear to occur most commonly in middle age or elderly females slightly more than other individuals. Some individuals may also have an anatomic predisposition to sustaining fifth metatarsal fractures. These patients normally have high arched feet and/or an alignment of the lower extremity that tends to load the outside part of their feet. What causes fifth metatarsal fractures?Ĭauses include falls, direct blows, sports, motor vehicle accidents, bony stress overload, and twisting injuries with the latter being the most common cause. High-energy injuries tend to cause multiple metatarsal fractures and usually are not solely responsible for an isolated fifth metatarsal fracture.
The fifth metatarsal can sustain a fracture (or break) in several different areas. The vast majority of fifth metatarsal fractures we see occur at the base of the fifth metatarsal compared to the shaft or neck of the metatarsal. At OrthoArizona, metatarsal fractures are some of the most common fractures we see. We typically see several new patients per day with metatarsal fractures. Of all of the metatarsal fractures we see, fractures of the fifth metatarsal are by far the most common.
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