Originally written by: Pearson Huggins OMSII. Updated: June 2022

A fifth metatarsal fracture is a break along the forefoot of the lateral tubular bone that is attached to the small toe. These are common fractures that result from various injuries to the foot and overuse.


What Is the 5th Metatarsal?

The fifth metatarsal is the long bone on the outside of the foot that connects to your pinky or little toe. There are three types of metatarsal fractures you might experience when you injure the fifth metatarsal.

Metatarsal fractures are classified into zones (1-3) and known as:

  • Avulsion fracture
  • Jones fracture
  • Dancer’s fracture (also known as a mid-shaft or diaphyseal fracture)


Fifth Metatarsal Fracture Causes

Avulsion fractures, Jones fractures, and dancer’s fractures are all common fractures that can result from various activities. Sometimes, they are stress fractures that result from ankle rolls and repetitive stress. More commonly, 5th metatarsal fractures occur from an injured foot, overuse, or high arches.

For example, a direct blow to the foot and ankle, landing on it with excessive force, or an ankle sprain are all possible causes of a fifth metatarsal fracture.

Fractures of the fifth metatarsal are the most common break because of one of these events. Luckily, they are easy to treat and may heal without surgery.

See a doctor as soon as possible after a significant foot injury.


5th Metatarsal Fracture Symptoms

After fracturing the fifth metatarsal, there are a variety of symptoms that may appear along the outside of the foot.

These include but are not limited to:

  • Tenderness
  • Swelling
  • Pain or discomfort

After fractures occur, you might have trouble walking and putting weight on that specific leg. It’s common to see bruising on the injured part of the foot and the surrounding area.

Walking after a fifth metatarsal fracture is possible, but some patients may experience too much pain.


Anatomy and Classification

The foot has seven tarsal bones (also known as ankle bones), five metatarsals, and fourteen phalanges. It is a complex structure responsible for weight-bearing and is often subject to injury through a tiny hairline break or stress fracture that can occur from overuse.

Your foot’s metatarsal bone is responsible for connecting the space between the tarsals, or cluster of articulating bones between the tibia and fibula, and the fourteen phalanges, or the bones in the tones.

The metatarsals are numbered 1-5, with the 5th metatarsal, the most commonly fractured bone in the foot is on the lateral or outside portion of the foot.


Types of 5th Metatarsal Fractures

There are three different types of fifth metatarsal fractures that a patient might be experiencing and the type of metatarsal fracture depends on how it was caused.

Learn the causes, symptoms, and treatments for each below.


Tuberosity Avulsion Fractures (Dancer’s Fracture)

Tuberosity avulsion fractures are also known as the dancer’s fracture. The fracture occurs when the ligaments and tendons attached to the metatarsal head of the 5th metatarsal pull off the bone.

If you’re a dancer, you may experience this type of fracture after an ankle sprain from twisting while wearing a stiff-soled shoe, repetitive stress, or over-rotating your foot and ankle, giving this fracture its colloquial name.


Jones Fracture

Jones fractures are mid-shaft fractures occurring in the portion of the bone between the metatarsal head and the shaft of the fifth metatarsal. Runners may be subject to this injury after over-intensive training, running on uneven surfaces, or running on the outside of the foot.

The Jones fracture is also the most serious of all three metatarsal fractures and may require the intervention of a foot and ankle surgeon. In some instances, however, surgical intervention is not necessary with the bone healing in three to four months after the initial injury.


Diaphyseal (Shaft) Fracture

A diaphyseal or shaft fracture is also known as a Zone 3 metatarsal fracture. Like Jones fractures, these sometimes require surgery and occur when the patient experiences midshaft fractures.


How Will the Doctor Assess My Foot?

When meeting with a doctor about your fifth metatarsal injury, the doctor will ask you about your injury, where the pain is, and your range of motion. Likely this will lead to X-rays or magnetic resonance imaging (MRI) that will tell the doctor exactly what kind of fracture has occurred.


Treatment and Recovery

Luckily, a fifth metatarsal fracture is relatively easy to treat. Although severely injured metatarsal bones may require surgery, most can heal with rest, ice, compression, and elevation (RICE) or bone stimulation.

There are different treatment options for each fifth metatarsal fracture type:

  • An avulsion fracture is usually non-operative, meaning it can heal without surgical treatment.
  • When Jones fractures occur, they sometimes require intervention from foot and ankle surgeons. They will take the injured foot and place it in a cast or boot.
  • Shaft fractures only need surgery if there is displaced bone.


Are you experiencing acute or chronic foot pain? Schedule an appointment with one of OrthoNeuro’s foot and ankle specialists. Call (614) 890-6555 today!

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