If providers treat your fracture with immobilization, you can expect to heal in six to eight weeks. Recovery from fifth metatarsal fracture surgery usually takes up to seven weeks. You’ll need to keep weight off your foot for at least six weeks.
Full Answer
When are avulsion fractures of the fifth metatarsal reduced and fixed?
Avulsion fractures of the base of the fifth metatarsal that are displaced greater than three millimetres or comminuted should be reduced and operatively fixed. Fracture reduction and fixation should be considered if the fracture fragment involves more than 30% of the cubometatarsal joint.
When to see a foot specialist for a broken fifth metatarsal?
When to see a foot pain specialist about a Broken Fifth Metatarsal: Pain, swelling and bruising along the outer foot edge after an injury. If you think you may have broken a bone you need to see a foot specialist and have an x-ray.
How long does it take for a 5th metatarsal fracture to heal?
It often takes 12 or more weeks for a full recovery to occur. Impact activity, such as running or sports can take up to 6 months for complete bone healing. This type of injury needs to be differentiated from a “ Jones fracture “, which occurs slightly further towards the center of the 5th metatarsal.
What causes pain in the base of the 5th metatarsal?
A patient who suffers an acute rolling of their ankle can also injure the base of the 5th metatarsal (See Figure 1). This will produce immediate pain over the outside aspect of the foot. It can be associated with significant swelling. Difficulty with balance due to weakness of the peroneus brevis also occurs.
How long does pain last after 5th metatarsal fracture?
How long will it take to heal? Most fractures heal without any problems in about six weeks. However, it may take three to six months for your symptoms to settle completely – these can include pain or discomfort, stiffness, decreased strength, and swelling.
How long does it take for an avulsion fracture of the 5th metatarsal to heal?
You have sustained a fracture to the base of the 5th metatarsal of your foot, which is known as an avulsion fracture. Please see the picture below to understand where this injury is. This normally takes approximately 6 weeks to unite (heal) although pain and swelling can be ongoing for 3-6 months.
How long does the pain last after a metatarsal fracture?
Pain levels can changes from day to day, it doesn't always depend on what you are doing. It is not unusual to have pain while you are resting because the bone is continually healing. It is normal to have some pain even when your fracture has healed and can take up to 12 months to settle.
Why is my 5th metatarsal fracture not healing?
It is possible for these factors to severely slow the bone healing process or even result in non-healing of your fracture: Smoking. Premature weight bearing (when non-weight bearing has been recommended) Excess weight bearing (when weight bearing is allowed)
Why does my avulsion fracture still hurt?
It is not unusual to have pain while you are resting because the bone is continually healing. It is normal to have some pain even when your fracture has healed and can take up to 12 months to settle. A range of different medications may be available to help reduce your pain to allow you to move comfortably.
Can an avulsion fracture get worse?
Your avulsion fracture can get worse if you don't follow your healthcare provider's advice.
Can a healed fracture still hurt?
When you suffer a fracture, it will eventually heal and recover to the point that you no longer experience pain. Unfortunately, this does not happen for everyone. Some people may continue to experience pain long after the fracture and soft tissues have finished healing.
How painful is a 5th metatarsal fracture?
Symptoms of a fifth metatarsal fracture Sudden pain along the outside of your foot is the main symptom. A stress fracture may develop more slowly. You may feel chronic pain for a period of time. Your foot may also swell up and bruise.
How long will a broken foot hurt?
A broken foot or toe may take 4–6 weeks to heal fully. However, in some cases, healing time can be as long as 10–12 weeks. Recovering individuals should follow the RICE method and any specific instructions from their doctor.
Why is my broken metatarsal not healing?
Causes and Risk Factors Blood brings oxygen, healing cells and growth factors to the bone to allow it to heal. If a fractured bone is left unstable or lacks blood supply, it can lead to a nonunion. Factors including the use of tobacco or nicotine can impede bone healing and increase the risk of nonunion.
Why is my foot fracture not healing?
Several factors contribute to a nonunion. If the bone ends that are fractured have been stripped away from the blood vessels that provide them with nutrition, they will die. As a result, the bone ends cannot contribute to new healing, and a nonunion is more likely.
How can you tell if a broken bone isn't healing?
“Patients who suspect their fracture has not healed after treatment or is not healing properly should look out for three things: pain at the site, deformity – the bone was straight and now it's bent – and impaired use or function – leg or ankle still cannot support weight.
What is the treatment for a fifth metatarsal fracture?
Taking everything into consideration, along with patient activity level, treatment can be nonoperative or operative .
What percentage of metatarsal fractures are primary care?
INTRODUCTION. Metatarsal fractures are frequently encountered injuries of the foot[1]. Approximately five to six percent of fractures encountered in the primary care setting are metatarsal fractures[2]. In adults, metatarsal fractures peak in the second to fifth decades of life.
How long does it take to union a Jones fracture?
Portland et al[25] demonstrated 100% union rate after immediate intramedullary fixation with 4.5-mm or 5.0-mm cannulated screws in acute Jones fractures (zone two) and Torg type I diaphyseal stress fractures, with an average time to union of 6.2 wk. Immediate intramedullary fixation of type II diaphyseal stress fractures resulted in 100% union and average time to union of 8.3 wk. They advocate for immediate intramedullary fixation of Jones fractures and acutely presenting Torg type I and II diaphyseal stress fractures[25].
What is metatarsal fracture?
Metatarsal fractures are one of the most common injuries of the foot. There has been conflicting literature on management of fifth metatarsal fractures due to inconsistency with respect to classification of these fractures. This article provides a thorough review of fifth metatarsal fractures with examination of relevant literature to describe ...
What is the standard radiographic view of the foot?
Radiographic imaging for a suspected metatarsal fracture includes three standard radiographic views of the foot: Lateral, anteroposterior, and a 45 degree oblique. Acute stress fractures are typically not detected on the standard three views of the foot. It is suggested that repeated radiographs are made at 10 to 14 d after the initial onset of symptoms[9]. At this time a radiolucent reabsorption gap around the fracture confirms the diagnosis[9]. In the case of more complex midfoot trauma, a CT scan is recommended to rule out the Lisfranc fracture dislocation[9].
Which fracture has nonunited?
Radiograph of a fifth metatarsal Torg type III fracture, which has nonunited.
Who first described a fracture of the proximal fifth metatarsal?
The first to describe a fracture of the proximal fifth metatarsal was Sir Robert Jones [7-9]. He described a fracture in the proximal three quarter segment of the shaft distal to the styloid[7-9]. The Jones fracture as described by Sir Robert Jones was later defined by Stewart[10,11] as a transverse fracture at the junction of the diaphysis and metaphysis without extension into the fourth and fifth intermetatarsal articulation. Since then there has been a focus in the literature on fractures of the proximal fifth metatarsal due to the propensity for poor healing of some fractures in this region. The blood supply to the proximal fifth metatarsal is important in understanding troublesome fracture healing in this area. The blood supply of the fifth metatarsal was investigated in a cadaver model by Smith et al[12]. They found that the blood supply arises from three possible sources; the nutrient artery, the metaphyseal perforators, and the periosteal arteries. A watershed area exists between the supply of the nutrient artery and the metaphyseal perforators which corresponds to the area of poor fracture healing in the clinical setting[12]. A classification system created by Torg et al[13] is based on healing potential. This classification simplifies proximal fifth metatarsal fractures as either involving the tuberosity or the proximal diaphysis distal to the tuberosity, the latter group being called the Jones fracture[13,14]. Under this system the Jones fracture is divided into three types based on the radiological appearance of the fracture[13]. Type I (acute) fractures are characterized by a narrow fracture line and an absence of intramedullary sclerosis[13,15,16]. The features of acute fractures in this classification are no history of previous fracture, although previous pain or discomfort may be present[13]. Torg type I fractures are presumed to be acute fractures at a site of pre-existing stress concentration on the lateral cortex that becomes acutely disabling when they extend across the entire diaphysis[13]. Type II (delayed union) are distinguished by having a previous injury or fracture with radiographic features of a widened fracture line and evidence of intramedullary sclerosis (Figure (Figure11)[13,15,16]. Type III (nonunion) are characterized by complete obliteration of the medullary canal by sclerotic bone with a history of repetitive trauma and recurrent symptoms (Figure (Figure22)[13,15,16]. Although the term Jones fracture was applied to the fractures in this classification, based on Torg’s description these fractures are more consistent with stress fractures. As a result, proximal fifth metatarsal fractures were re-classified to avoid the confusing term of Jones fractures. Proximal fifth metatarsal fractures can be classified into three zones as described by Lawrence et al[3] and Dameron[4,5]. Tuberosity avulsion fractures represent zone one (Figure (Figure33)[3-5]. Zone two (Jones fracture) is described as a fracture at the metaphysis-diaphyseal junction. Zone three or diaphyseal stress fractures include the proximal 1.5 cm of the diaphysis[3,4,5,9,17]. This classification is straightforward however, it must be noted that their description of zone two is a slight mis-representation of the true Jones fracture as described by Stewart[11]. It is important to note that the Jones fracture in this classification system is an acute injury with no prodrome whereas zone three fractures have a variable prodome[3]. The distinction between Jones (zone two) and proximal diaphyseal stress fractures (zone three) is commonly confused in the literature which potentially obscures important differences in prognosis and treatment[3,4,10,15]. A systematic review done by Dean et al[14], looked at the classification of Jones fractures in 19 studies. They found that the majority of authors did not differentiate between fractures involving the fourth/fifth intermetatarsal articulation from more distal fractures. They concluded that the Jones fracture is generally applied to all fractures of the proximal fifth metatarsal distal to the tuberosity within 1.5 cm of this region. However, because this is not a universal definition it very difficult to recognize differences in outcomes between operative and nonoperative management of zone two and zone three fractures in the literature. It also indicates that in many cases the literature fails to differentiate the chronicity of zone two and zone three fractures[14].
What is the tenderness of the metatarsal?
When pressing on the outside of the foot, there will be marked tenderness at the base of 5th metatarsal. There may be tenderness over a large area of the outside of the foot. However, the main tenderness will be at the base of the 5th metatarsal. On exam, it is determined if the patient can still move their foot to the outside (eversion of the foot). This is done by placing the foot in an everted position and asking them to maintain that position against some resistance. This assesses for continuity of the tendons that evert the foot. Doing this usually creates some discomfort for the patient. However, they usually are able to perform the action though with decreased strength compared with the opposite side.
What is the avulsion on the foot?
X-ray of the foot will reveal an avulsion (“pulling off”) fracture of the base of the 5th metatarsal. The size of the fractured fragment may vary considerably. There will be more gapping at the fracture site, plantarly (on the bottom of the foot) and on the outside of the bone (lateral side), compared to the inside of the bone (medial side – Figures 3A and 3B).
How to heal a fractured foot?
If the patient has the ability to actively move the foot outwards (eversion), the injury will likely heal with non-operative treatment. Treatment involves relative rest and time to allow the fracture to heal. Typically, patients are placed in a walking boot to immobilize the peroneus brevis tendon.
Why does my foot turn blue and black?
It can be associated with significant swelling. Difficulty with balance due to weakness of the peroneus brevis also occur s. Over time, the skin can turn black and blue. It will be associated with quite specific local tenderness over the base of the bone, on the outside of the foot (the 5th metatarsal).
How long does it take for a fractured bone to heal?
It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level.
How long does it take for a foot to heal from a heel injury?
Usually by 6 weeks, there is enough healing to allow them to transition to a stiff-soled shoe with lots of padding. This is a frustrating injury because it takes a long time for healing to occur. Patients are often still symptomatic 8 weeks or more after this injury.
How to determine if a patient can move their foot to the outside?
This is done by placing the foot in an everted position and asking them to maintain that position against some resistance. This assesses for continuity of the tendons that evert the foot.
What is a fifth metatarsal fracture?
Another type of fifth metatarsal fracture is a horizontal or transverse fracture through the junction of the base and shaft of the bone. This is sometimes called a “Jones Fracture”. Since the blood supply to this area is poor, Jones Fractures are more prone to difficulty in healing.
What to do if you break your metatarsal?
Surgical treatment options for a break in the fifth metatarsal maybe recommended by your foot and ankle specialist if you have one of the following types of fractures: 1 Avulsion Fracture#N#If an Avulsion Fracture results in a large displaced fracture fragment open reduction and internal fixation with plates and screws may be necessary. 2 Jones Fracture#N#Because of its location on the bone, a Jones Fracture may take longer to heal. In some cases, a Jones Fracture may not heal at all, a condition called “nonunion.” When this happens surgery is often required to treat the fracture similar to Avulsion Fracture surgery.
What is it called when a tendon pulls away from the base of the metatarsal?
The tendon that attaches to the base of the fifth metatarsal may stretch and pull a fragment of bone away from the base. Since the fragment is pulled away from the rest of the bone, this type of injury is called an “avulsion fracture”.
Why does a Jones fracture take so long to heal?
Jones Fracture. Because of its location on the bone, a Jones Fracture may take longer to heal. In some cases, a Jones Fracture may not heal at all, a condition called “nonunion.”. When this happens surgery is often required to treat the fracture similar to Avulsion Fracture surgery.
Where is the fifth metatarsal bone?
The fifth metatarsal is the long bone on the outside of the foot. Most commonly the fifth metatarsal fractures through the base of the bone.
What happens if you break a bone in your foot?
Pain, swelling and bruising along the outer foot edge after an injury. If you think you may have broken a bone you need to see a foot specialist and have an x-ray
How to reduce swelling in ankle after surgery?
Elevate leg above the heart as much as possible to control swelling and inflammation. No impact or cutting exercises/activities for 6 weeks post-op.
How to return to specific sports?
Start sport-specific training. Increase the intensity of strength, balance, coordination and functional training for gradual return to activities and sports. Return to specific sports is determined by the physical therapist through functional testing specific to the targeted sport.
How long can you walk with crutches after a swollen leg?
Patient will be walking with crutches non-weightbearing until most of the swelling resolves. Patient may be in a removable boot after surgery for a week or two at the direction of the physician. Limit unnecessary walking or standing for the first week to control swelling and pain.
Clinical Presentation
Physical Examination
- When pressing on the outside of the foot, there will be marked tenderness at the base of 5th metatarsal. There may be tenderness over a large area of the outside of the foot. However, the main tenderness will be at the base of the 5th metatarsal. On exam, it is determined if the patient can still move their foot to the outside (eversion of the foot). This is done by placing the foot in a…
Imaging Studies
- X-ray of the foot will reveal an avulsion (“pulling off”) fracture of the base of the 5th metatarsal. The size of the fractured fragment may vary considerably. There will be more gapping at the fracture site, plantarly (on the bottom of the foot) and on the outside of the bone (lateral side), compared to the inside of the bone (medial side – Figures 3A and 3B).
Treatment
- A 5th metatarsal avulsion fracture is an injury that is usually treated non-operatively. If the patient has the ability to actively move the foot outwards (eversion), the injury will likely heal with non-operative treatment. Treatment involves relative rest and time to allow the fracture to heal. Typically, patients are placed in awalking boot to i...