Foot Fracture: Fifth Metatarsal Fracture

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KEY POINTS

• A fifth metatarsal fracture is a break or crack in the long foot bone that attaches to the little toe.
• Treatment may include surgery, a stiff-soled shoe, cast, or removable cast, and special exercises to help your foot get stronger and more flexible.
• Follow the full course of treatment your healthcare provider prescribes.

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What is a fifth metatarsal fracture?

A fifth metatarsal fracture is type of foot fracture. It is a break or crack in the long foot bone that attaches to the little toe. The break may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

The long bones in the foot are called the metatarsals.

What is the cause?

A fifth metatarsal fracture can happen several ways. It may happen when the foot rolls or twists or when a heavy object lands on the foot. Sometimes bones wear out and break from overuse, like during sports or activities where you are on your feet a lot. This type of fracture is called a stress fracture. A fracture may also be the result of a medical condition that causes weak or brittle bones.

What are the symptoms?

Symptoms may include:

• Pain, swelling, bruising, or tenderness that happens right after the injury, usually on the outer side of the foot
• Pain when the injured area is touched or that keeps you from putting weight on your foot
• An area of the foot that is cold, pale, or numb
• A change in the shape of the foot

How is it diagnosed?

Your healthcare provider will ask about your symptoms and how the injury happened. Your provider will examine you. Tests may include:

• X-rays of the foot
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones
• Bone scan, which uses a radioactive chemical to look at your bones

How is it treated?

The treatment depends on the type of fracture.

• If you have an open wound with the fracture, you may need treatment to control bleeding or prevent infection.
• If the broken bone is crooked, your healthcare provider will straighten it. You will be given medicine first so the straightening is less painful.
• Sometimes surgery is needed to put the bones back into the right position.
• You may need to have a stiff-soled shoe, cast, or removable cast for several weeks.
  • If you have a cast, make sure the cast does not get wet. Cover the cast with plastic when you bathe. Avoid scratching the skin around the cast or poking things down between the cast and your skin. This could cause an infection.
  • Your provider will tell you how much weight you can put on your foot, if any. Use crutches, a knee walker, or a cane as directed by your healthcare provider.

With treatment, most foot fractures take up to 6 weeks to heal. You may need to do special exercises to help your foot get stronger and more flexible. Ask your healthcare provider about this.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the foot up on pillows so that it is above the level of your heart when you sit or lie down.
  • Take pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a fifth metatarsal fracture?

Most foot fractures are caused by accidents that are not easy to prevent. However, shoes that fit well and give good support can help prevent injury.