Fractured Fifth Metatarsal

Another injury common in basketball in a fracture of the fifth metatarsal, which is a bone on the outside of the foot. There are two different types of acute fracture to this bone, depending on the region of the bone that is injured.

The first type of proximal fifth metatarsal fracture is a styloid avulsion fracture. This is a fracture of the most proximal region of the bone. The mechanism of injury is usually a sudden inversion or rolling in of the ankle and foot. In a styloid fracture, there is painful swelling and bruising of the lateral side of the foot. There may be difficultly bearing weight on that foot due to the pain. Radiographs show a transverse or horizontal line on the most proximal end of the metatarsal. Treatment of this fracture includes icing, elevation and wearing a firm-soled shoe, walker boot or cast for a couple of weeks. Crutches may be needed initially if walking is painful. If the bone fragment is displaced, surgery may be needed. In most styloid fractures, activity can be advanced as tolerated. Pain is usually resolved after about four weeks.

A second, more severe type of acute fracture of the proximal fifth metatarsal is a Jones fracture or metaphyseal-diaphyseal junction fracture. This fracture occurs due to a sudden force under the lateral foot such as when landing from a high jump on another player’s foot. There is pain and swelling of the lateral foot. Weight bearing is usually not possible due to pain. Radiographs show a transverse fracture through the proximal metatarsal and extending into the joint between the bases of the fourth and fifth metatarsal. Treatment of a Jones fracture includes icing, elevation and non-weight bearing. A cast is usually worn for at least six to eight weeks. This fracture may not heal with casting and may need surgical treatment.

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