Strategies for managing fifth metatarsal base fractures

Fifth metatarsal base (FMB) fractures are among the most common fractures of the foot. Time to healing and time to return to activity depend on the location of the fracture, the presence of certain features or complications, and use of conservative or surgical management. This article provides a comprehensive overview of FMB fractures, including their classification by location or zone, diagnosis, and management based on fracture characteristics and complications. It emphasizes the role of advanced practice providers in recognizing cases requiring surgical intervention, and it provides management recommendations based on the current evidence base and the authors' practice experience to ensure optimal patient healing.