A fifth metatarsal fracture is a common injury where the bone connecting your ankle to your little toe breaks. These fractures occur from injury, overuse or high arches. Providers can treat your broken bone with a cast, boot or shoe — or with surgery. Using ice, keeping weight off your foot and elevating your foot can help decrease recovery time.
A fifth metatarsal fracture is a broken bone on the outer edge of your foot and one of the most common foot injuries. Your fifth metatarsal is the long bone on the outside of your foot that connects to your little toe.
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There are three types of fifth metatarsal fractures classified into three zones:
About 5% to 6% of fractures seen by U.S. healthcare providers are metatarsal fractures. Anyone can get a fifth metatarsal fracture, but this type of fracture peaks for men in their 30s and women in their 70s. Women tend to have a higher rate of avulsion and mid-shaft fractures than men.
Trauma to your foot causes a fifth metatarsal fracture. This trauma may result from:
If you have a fifth metatarsal fracture, you may experience trouble walking. You may also have the following symptoms on the outside of your foot:
Your healthcare provider will ask about when and where the pain started. Your provider will also press gently on your foot to find the location of the pain. They may also request some imaging tests:
Treatment for a fifth metatarsal fracture depends on whether the broken bones have moved out of place. Treatment also depends on your:
Treatments for fifth metatarsal fractures include:
Immobilization: If your bones are in place (aligned), your provider may suggest immobilization. This is usually the only treatment necessary for zone 1 (avulsion). Providers may also treat zone 2 (Jones) fractures with immobilization as a first step.
During this treatment, you keep your foot stabilized in a cast, boot or stiff-soled shoe while your injury heals. You may also need to use crutches. Immobilization usually lasts from six to eight weeks.
Surgery: If your bones are out of place (displaced) more than 3 mm or if you’re an elite athlete, your provider may recommend surgery. Providers often recommend surgery for zone 2 (Jones) fractures when nonsurgical treatment doesn’t work. It is also often suggested for zone 3 (mid-shaft or dancer’s) fractures.
In this procedure, a foot and ankle surgeon will place a pin, screw, rod or plate into your foot to keep the bone in place. The insertion will stay in place after your bone heals.
Some cases require your surgeon to remove damaged bone around the fracture and replace it with a bone graft. They may also use a bone healing stimulator, which sends an electrical current to stimulate healing.
Complications of treatment vary from person to person. The most common complications include:
You can improve your recovery time by:
If providers treat your fracture with immobilization, you can expect to heal in six to eight weeks. Recovery from fifth metatarsal fracture surgery usually takes up to seven weeks. You’ll need to keep weight off your foot for at least six weeks.
You can typically return to your regular activities, including sports, three to four months after surgery or immobilization. Your provider may recommend physical therapy to help restore mobility in your foot.
See your provider if you develop a fever or have any of the following symptoms in your foot or leg:
A note from Cleveland Clinic
Fifth metatarsal fractures are very common. After your provider treats your broken bone, you can take care of yourself by resting your foot and keeping it elevated when you’re sitting. You can generally return to your regular activities several months after your treatment.
Last reviewed by a Cleveland Clinic medical professional on 12/29/2021.
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