The 5th metatarsal, the long bone on the outer side of the foot, is particularly prone to injury due to its location and shape. Trauma often leads to fractures in this bone, and understanding these injuries can help in prompt and effective treatment. Let’s delve into the details of 5th metatarsal fractures and their management.
Types of 5th Metatarsal Fractures
There are two primary types of fractures in the 5th metatarsal, classified based on their location:
Avulsion Fracture
Commonly known as a "dancer’s fracture," an avulsion fracture occurs when a small piece of bone is pulled off the main portion by a tendon or ligament. This injury typically happens when the ankle rolls and is often overlooked, especially when it coincides with an ankle sprain.
Jones Fracture
A Jones fracture is the most common fracture site at the base of the fifth metatarsal. It occurs due to the inversion of the forefoot and can manifest either as a stress fracture (a tiny hairline break over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress, or trauma. They are less common but more challenging to treat compared to avulsion fractures.
Other types of fractures in the fifth metatarsal include midshaft fractures, usually resulting from trauma or twisting, and fractures of the metatarsal head and neck.
Recognising the Symptoms
Identifying the symptoms of a 5th metatarsal fracture is crucial for timely treatment.
Common symptoms include:
Pain, bruising, swelling, and redness around the area
Night pain that disrupts sleep
Difficulty placing pressure on the affected foot
Treatment Approaches
The treatment plan for a 5th metatarsal fracture depends on the type and location of the fracture. Here are the general steps involved:
PEACE and LOVE Protocol
This approach includes Protect, Elevate, Avoid anti-inflammatory modalities, Compress, Educate, and Load, Optimism, Vascularisation, Exercise. It promotes healing and prevents further injury.
Immobilisation
Typically, a Controlled Ankle Movement (CAM) walker is used to immobilise the foot and allow the bone to heal.
Training Modification
Adjusting or restricting physical activities to avoid stress on the injured area is essential.
Imaging and Orthopaedic Consultation
X-rays or other imaging techniques, along with an orthopaedic opinion, are valuable in determining the most effective management plan for a dancer or athlete’s return to full training.
Understanding the types, symptoms, and treatment of 5th metatarsal fractures is essential for anyone involved in physical activities, particularly dancers and athletes. Prompt recognition and appropriate management can ensure a swift and complete recovery, allowing individuals to return to their activities with confidence.
If you suspect a 5th metatarsal fracture or have any foot-related concerns, consult with a Physiotherapist to get the right diagnosis and treatment plan.
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