Fractures of the fifth metatarsal; diagnosis and treatment

Of all foot fractures the fifth metatarsal fracture is the most common. A complete clinical and radiological assessment is required to select the best treatment option. Nondisplaced tuberosity avulsion fractures can be treated non-operatively. Surgical treatment is indicated when the fracture is displaced more than 2mm or when more than 30% of the cubometatarsal joint is involved. Non or minimally displaced shaft fractures can be treated non-operatively. If the dislocation is more than 3-4mm or the angulation is more than 10 degrees, percutaneous K-wires, plate or screw fixation is indicated. The Jones fracture is known for prolonged healing time and non-union. The indication for surgical treatment of Jones' fractures depends on activity level and Torg classification: type I fractures are treated non-operatively. Type II fractures can be treated non-operatively or operatively, depending on patient activity level. Type III fractures have more complications and should be treated operatively. Several operation techniques have been described.