Condition Articles-Base of the Fifth Metatarsal Fractures PDF

Base of the Fifth Metatarsal Fractures PDF

Pdf Summary

Base of the fifth metatarsal fractures are fractures that occur between the tuberosity and proximal diaphysis of the metatarsal bone in the foot. There are three groups of fractures based on their location, injury mechanism, and timing of injury. The base of the fifth metatarsal is comprised of the tuberosity, metaphysis, and proximal diaphysis. The tuberosity is covered by the peroneus brevis tendon insertion and has a plantar process and a facet for articulation. The metaphysis is distal to the tuberosity and features a medial facet for articulation with the fourth metatarsal. The proximal diaphysis extends 1.5 cm distal to the metaphysis.<br /><br />The articulation between the fourth and fifth metatarsals is stabilized by strong dorsal and plantar intermetatarsal ligaments. Fractures can occur in three zones of the base of the fifth metatarsal: tuberosity avulsion fractures, acute Jones fractures, and diaphyseal stress fractures. Patients with fractures report sudden onset of pain and swelling localized to the proximal fifth metatarsal. Examination may reveal swelling, ecchymosis, and point tenderness, and imaging studies such as x-rays and MRI can confirm the presence of a fracture.<br /><br />Treatment for base of the fifth metatarsal fractures depends on the specific location and severity of the fracture. Zone 1 fractures tend to heal well and can be treated with rest, ice, elevation, and NSAIDs. Zone 2 and 3 fractures are at increased risk of delayed or nonunion and may require non-weight bearing in a cast for several weeks or surgery with internal fixation. Elite athletes may require surgery to expedite their return to physical activity.<br /><br />In conclusion, accurate diagnosis and appropriate management of base of the fifth metatarsal fractures can be achieved through careful assessment of the patient's history, physical exam, and radiographic findings.

Keywords

base of the fifth metatarsal fractures

tuberosity

proximal diaphysis

fracture location

injury mechanism

timing of injury

peroneus brevis tendon insertion

metaphysis

proximal diaphysis extension

intermetatarsal ligaments