$distal metatarsal fracture$ $distal metatarsal fracture$

The fracture has a very high rate of healing with non-operative treatment. Figure 3A: X-ray from the side (Lateral View)Ī 5th metatarsal shaft “Dancer’s” fracture is an injury that is usually treated non-operatively. There will be gapping at the fracture and there may be some shortening or rotation of the fracture (Figures 3A-3B). The usual fracture pattern is a spiral running from the outside aspect of the bone (distal lateral) near the toes to the inside aspect of the bone near the ankle (proximal medial). The size of the fractured fragment may vary considerably. X-rays of the foot will reveal a long oblique fracture of the shaft of the 5th metatarsal. However, the main tenderness will usually be just before the base of the fifth toe. There may be tenderness and swelling over a large area of the outside of the foot. When pressing on the outside of the foot, there will be marked tenderness over the 5th metatarsal. Figure 2: Twisting mechanism causing injury The injury is associated with quite specific local tenderness over the bone near the base of the fifth toe and on the outside of the foot (the 5th metatarsal). Over time, the skin can turn black and blue. Weight bearing on the injured foot may be difficult due to pain and discomfort. It can be associated with significant swelling. This will produce immediate pain over the outside aspect of the foot near the toes. An acute rolling of their ankle while pointing the toes down can also fracture the shaft of the 5th metatarsal (See Figure 1). Figure 1: 5th Metatarsal Shaft “Dancer’s” FractureĪ patient who suffers a 5 th metatarsal shaft fracture (See Figure 1) commonly gives a history of a twisting and loading injury to their ankle and foot (inversion and plantarflexion injury), similar to what occurs with an ankle sprain (Figure 2). However, since this fracture of the fifth metatarsal was first described in ballet dancer’s, it has become known as a dancer’s fracture as well. **There is another fracture ( 5th metatarsal avulsion fracture) that may also be referred to as a dancer’s fracture. It often takes 4 or more months for a full recovery to occur. It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level. In many instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing. The injury causes localized pain, swelling, and difficulty walking. This 5th metatarsal shaft fracture is sometimes called a “Dancer’s fracture”. During this injury, the 5th metatarsal is twisted by a strong force resulting in a spiral fracture. Eponym A Day.5th Metatarsal Shaft “Dancer’s” Fracture SummaryĪ twisting injury to the ankle and foot may cause a long oblique fracture of the 5th metatarsal shaft - the bone that attaches the little toe to the midfoot (Figure 1). Proximal Fifth Metatarsal Fractures: Anatomy, Classification, Treatment and Complications. Acute fractures to the proximal fifth metatarsal bone: development of classification and treatment recommendations based on the current evidence. Polzer H, Polzer S, Mutschler W, Prall WC.Fractures of the fifth metatarsal diagnosis and treatment. The epidemiology of metatarsal fractures. Jones’ fractures and related fractures of the proximal fifth metatarsal. Fractures of the base of the fifth metatarsal distal to the tuberosity.

$distal metatarsal fracture$

Classification and guidelines for non-surgical and surgical management. Torg JS, Balduini FC, Zelko RR, Pavlov H, Peff TC, Das M.Jones’s fracture: fracture of base of fifth metatarsal. Fracture of the Base of the Fifth Metatarsal Bone by Indirect Violence. He named the latter: ‘ Jones fracture’.ġ984 – Torg et al reported fractures of proximal diaphysis are likely located at a site of pre-existing stress pressure.ġ993 – Lawrence and Botte release a classification system distinguishing 3 zones 1902: 697ġ960 – Stewart differentiated an avulsion fracture of the tuberosity / styloid from fractures of the proximal diaphysis. This was done, and the fifth metatarsal was found fractured about three-fourths of an inch from its base. I hobbled down-stairs to my colleague…to X-ray my foot. There was a slight swelling over the base of the fifth metatarsal bone… A finger on the spot gave exquisite pain…Extension of the ankle and flexion of the toes were immediately felt at the base of the fifth metatarsal. Something gave way midway down my foot, and I at once suspected a rupture of the peroneus longus tendon…The following morning I carefully examined my foot and discovered that my tendon was intact. Whilst dancing, I trod on the outer side of my foot, my heel at the moment being off the ground.

$distal metatarsal fracture$

Distal metatarsal fracture