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What is a fracture of the fifth metatarsal?



There are three different fractures of the fifth metatarsal:
  1. fracture of the tuberosity at the base of the fifth metatarsal
  2. fracture of the diaphysis known as a Jones’ fracture
  3. acute spiral fracture of the distal third of the fifth metatarsal—‘fouette fracture’
Physiotherapy is essential following a fracture of the fifth metatarsal.


Assessment of the foot and ankle by specialist therapistAbove: Assessment of the foot and ankle by specialist therapist



How does a fracture of the fifth metatarsal happen?

  1. The fracture of the tuberosity at the base of the fifth metatarsal is usually an avulsion injury (where the tendon pulls off a small piece of bone) that results from an acutely sprained ankle.
  2. The Jones’ fracture may be the result of the foot rolls inwards whilst the toes are pointed downwards) or, more commonly, as a result of overuse.
  3. The acute spiral fracture of the distal third is seen especially in dancers who suffer this fracture if they lose their balance while on their toes (demi pointe) and roll over the outside border of the foot.

What should I do if I have a fractured fifth metatarsal?



If you have or suspect you have a fracture of the fifth metatarsal bone you should not continue to perform activity on the foot. You should go to your nearest accident and emergency department as soon as possible. The RICE regime should also be commenced.


What shouldn’t I do if I have a fractured fifth metatarsal?



You shouldn’t continue to exercise if you suspect that you have fractured your fifth metatarsal.


Mobilisations and stretches of the foot and ankle by specialised therapistAbove: Mobilisations and stretches of the foot and ankle by specialised therapist



Treatment for a fracture of the fifth metatarsal

  1. Avulsion fractures of the tuberosity at the base of the fifth metatarsal usually heals well with a short period of immobilization for pain relief.
    1. A Jones’ fracture is usually treated with six to eight weeks of non-weight-bearing in a cast.
    2. If a rapid return to activity is required, immediate surgical fixation with the insertion of a screw may be indicated.
  2. Undisplaced spiral fractures of this type may be treated with weight-bearing rest, while displaced fractures may require four to six weeks of cast immobilization.
Physiotherapy may include:


Foot and ankle assessment conducted by specialist MSK physiotherapistAbove: Foot and ankle assessment conducted by specialist MSK physiotherapist



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


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