Feet > Fifth Metatarsal Fracture > Treatments


Treatment Introduction

Most fifth metatarsal fractures, except a Jones’ fracture where the shaft and base of the bone meet, are treated symptomatically. This means your physician prescribes whatever non-surgical treatment is needed to ease your pain. You usually can bear some weight on your foot right away as you can tolerate the pain. Depending on your pain, you may need to use crutches at first. As your pain decreases, your weight bearing can increase. Everyone is put on a slightly different schedule, but in general, it takes about six to eight weeks to heal a fifth metatarsal fracture. During the first few days, your physician may recommend resting with your foot elevated above the level of your heart to keep swelling down. If your fracture is preventing you from walking, your physician usually immobilizes your foot and ankle in a removable brace called a cam walker. A cam walker is a removable hard plastic boot, made with nylon straps that fasten around your calf and foot. Most cam walkers have an adjustable hinge at the ankle that can be set to allow the range of motion your physician prescribes. The sturdy bottom of the cam walker is rocker shaped, which enables you to walk. Most patients wear a cam walker for two weeks and then go into a cast shoe. This open-sandal shoe has a hard, plastic bottom that does not bend. When wearing the cast shoe, your foot does not flex when you take a step, which takes pressure off your fifth metatarsal. If you are not in a lot of pain, your physician may skip the cam walker and instead put your foot into a cast shoe. Treatment is a gradual process of weaning yourself from the cam walker, to the cast shoe, and then back into normal shoe wear. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Rehabilitation [top]

Most people do not need formal physical therapy to recover from a fifth metatarsal fracture that has not required surgery. Before you return to normal shoe wear, your physician usually instructs you to steadily increase your weight bearing exercises. As pain permits, begin with short walks one to two weeks after the injury while wearing your cam walker or cast shoe. The key is to avoid pain. Do not walk distances that cause discomfort in your foot. After a few weeks, you may be able to ride a stationary bicycle with your cast shoe on to help improve your fitness. Upper body workouts and swimming also can increase your cardiovascular fitness. As pain decreases, slowly increase the duration of your walks. A safe way to increase your workouts is by 10-percent increments. For example, if you walk one mile on Saturday, continue walking one mile for about a week, and do not go further than 1.10 miles on the following Saturday. If your workout causes pain, decrease its intensity or duration. Your fracture usually takes about six to eight weeks to heal before you can return to normal shoe wear. Most patients can return to sports and activities about ten weeks after the injury. Test your foot strength before returning to strenuous activities. You should be able to run, jump, and cut side-to-side without pain. If your foot continues to hurt, speak with your physician before returning to activities, as you may need further treatment. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Prevention [top]

To prevent complications after a fifth metatarsal fracture, it is important to make stretching and strengthening exercises part of your everyday routine. A strong and flexible foot will be less likely to suffer reinjury. Though it is hard to avoid accidents that cause traumatic injuries to your foot, you can be cautious during your training and activities to avoid drastic increases in the duration or intensity or your workouts. Your fifth metatarsal should heal and return to full strength, but if you feel pain return, especially after a period of overuse or high intensity training, you should visit your physician as soon as possible.

SHOES [top]

Finding a shoe with the proper shape and support for your foot can help prevent abnormal foot strain. Your athletic shoes should have good shock absorption in the heel, good flexibility, and sturdy materials to prevent side-to-side motion. Try to minimize the time you spend walking in unpadded dress shoes or boots. If your physician has prescribed orthotic inserts, you should continue to wear them in all your shoes. Based on your activity level, shoe inserts may wear out within six months and need to be replaced. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

   Treatment Introduction
Closed Reduction and Internal Fixation

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