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What is an avulsion fracture of the base of the fifth metatarsal?



The fifth metatarsal is a long thin bone that runs along the outside border of the foot. It runs from the middle of the outside border of the foot to base of the little toe. An avulsion fracture of the base of the fifth metatarsal occurs when a small piece of the metatarsal bone is pulled off from the rest of the bone. Physiotherapy is a successful treatment of avulsion fracture of the base of the fifth metatarsal.


How does an avulsion fracture of the base of the fifth metatarsal happen?



An avulsion fracture of the base of the fifth metatarsal can occur if the ankle is twisted inwards. When the ankle is twisted inwards a muscle called the peroneus brevis contracts to stop the movement and protect the ligaments of the ankle. This muscle is attached to the base of the fifth metatarsal. A very strong contraction can pull the muscle off from where it attaches to the metatarsal. In doing so, it can also pull off (or avulse) a piece of the metatarsal bone.


What are the symptoms of an avulsion fracture of the base of the fifth metatarsal?



An avulsion fracture of the base of the fifth metatarsal causes pain along the outside border of the foot. Pain is often worsened by standing on the injured foot. Other symptoms include:

What should I do if I have an avulsion fracture of the base of the fifth metatarsal?



If you suspect that you have an avulsion fracture of the base of your fifth metatarsal you should avoid putting weight through your foot and arrange a physiotherapy appointment as soon as possible. You can start the RICE regime (Rest, Ice, Compression, Elevation) to help control the amount of swelling and pain to your foot.


What shouldn’t I do if I have an avulsion fracture of the base of the fifth metatarsal?



If you suspect that you have an avulsion fracture of the base of your fifth metatarsal you should not put weight through your foot or undertake activities which increase blood flow to the injured area. These include hot showers, heat rubs, the consumption of alcohol and excessive activity.


Physiotherapy treatment following an avulsion fracture of the base of the fifth metatarsal.



Physiotherapy is important in the treatment of an avulsion fracture of the base of the fifth metatarsal. Initially, your physiotherapist can determine which tissues have been damaged and establish the extent of the damage. If you have an X-ray report you should bring this with you to your initial assessment. Following your initial assessment, an appropriate treatment plan can be developed. You may be required to use crutches for a couple of weeks to allow healing to occur and your pain to settle. Your physiotherapist can then use a number of techniques to accelerate your recovery. These include:

Could there be any long-term effects from an avulsion fracture of the base of the fifth metatarsal?



Avulsion fractures of the base of the fifth metatarsal normally heal within a matter of weeks and do not produce any long term effects, if they are appropriately treated. However, if the ankle is twisted inwards, it is common to also damage the ligaments that support the ankle and the other surrounding structures. Injury to these structures may prolong your recovery.

To arrange a physiotherapy assessment call Physio.co.uk on 0330 088 7800 or book online.


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