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$5th metatarsal fracture in child$

This can cause lateral foot overload, resulting in a stress fracture and non healing of the 5th metatarsal. People with this foot shape tend to walk on the outer aspect of their foot. It may be necessary to alter the biomechanics of the foot. For recurrent fractures or non healing fractures in patients who have very high arched feet (pes cavus). Operative management is as for Zone 2: Jones fracture. In patients managed non-operatively, if recovery has been complicated by painful non union particularly in the presence of significant displacement surgery is indicated.Īn x-ray showing a plate fixation for a 5th metatarsal fracture When there is significant displacement a patient may choose to undergo surgical fixation of the fracture. Very rarely is it necessary to operate on these fractures acutely. Patients should understand that the decision to undergo surgery should not be taken lightly.Ī variety of surgical options exist which need to be tailored to the individual and the stage of the disease. There is an argument that operative treatment can also enhance recovery and healing times which may be important for example in patients who wish to return to sports sooner. Surgical management is reserved for patients who have failed to respond to non operative treatment or when a decision has been made to pursue surgery due to the high complication rate associated with non operative management, for example non union.

Metabolic bone disease (for example thyroid problems).

Poor blood supply (including peripheral vascular disease).

Use of steroids or other immunosuppressant.

Weight bearing too early or excessively.

General risk factors for delayed healing, or non union of fractures include: In patients with a foot and lower limb that lends itself towards lateral overload (High arched feet – Pes cavus for example) there may be a higher risk of developing non-union and repeat fractures. In addition as these fractures are related to repetitive stress at the level of the fracture site, there is always a concern that the fracture may recur. The same can be said for these fractures. Due to the high risk of non union many patients decide to have surgical fixation. This means that it may take longer for the bone to heal (delayed union), or that the bone may not heal at all (non union). However, as discussed earlier the area of the bone that is fractured has a relatively poor blood supply. Approximately 66-75% of these fractures will heal with conservative management. There is a small risk of non union particularly if there is significant displacement.Īs with most fractures a Jones fracture will usually heal if the foot it protected from weight bearing for a long enough period of time. The majority of these injuries heal with conservative management without complication. X-ray of the foot demonstrating the zones of injury in base of 5th metatarsal fractures

$5th metatarsal fracture in child$

This injury is associated with sports such as football and rugby.

$5th metatarsal fracture in child$

It occurs at the junction of the metaphysis and diaphysis of the metatarsal bone (where the widened part of the bone at its end begins to thin out as it becomes the shaft of the bone). The mechanism of injury is similar to an avulsion injury. When the ankle is forced inwards, the pull on the muscle and its tendon is strong enough to pull a bit of bone off. While as the name suggests it occurs in dancers, anyone can get this fracture, from a trivial injury such as stepping off a kerb.Ī muscle in the leg called peroneus brevis attaches via its tendon to the base of the 5th metatarsal. A twisting injury to the foot and ankle literally pulls (avulsion) of a small piece of bone at the base of the 5th metatarsal. These injuries are also known as a Dancer’s fracture. Zone 1: Avulsion 5th metatarsal base fracture Foot x-ray demonstrating the zones of injury from 5th metatarsal fractures

$5th metatarsal fracture in child$