Feet > Fifth Metatarsal Fracture > Treatments


Treatment Introduction

Jones’ fractures or stress fractures of your fifth metatarsal, where the shaft of the bone meets the base, typically are treated in a cast for about eight weeks. This area of your fifth metatarsal is more difficult than others to heal, and physicians generally prescribe crutches so you can keep all your body weight off your foot while you wear the cast. A short leg cast wraps around your foot, ankle, and lower leg. Made of layers of fiberglass, it starts below your knee and is open around your toes to allow toe movement. Your physician rolls a thin, elastic stocking, called a stockinette, over your skin and then pads your leg with soft-roll bandages. A dry layer of fiberglass is wrapped around your leg and foot. Extra fiberglass strips are wrapped around the sole of your foot. Additional fiberglass layers are applied wet over the first layer. When the short leg cast dries, it should immobilize your foot and ankle but still allow you to move your toes. It should be snug, but not tight. The cast may be applied in your physician’s office the same day as the diagnosis is made. You usually are sent home with instructions to keep your leg elevated when resting and to use crutches when you need to get around.

Home Recovery [top]

While wearing your short leg cast for about eight weeks after your fifth metatarsal fracture, it is important to retain blood circulation and movement in your toes. Wiggle your toes and pinch them to check for numbness. Though swelling is rare, if your toes become numb you should call your physician to receive a new cast. It is essential to keep as much weight as possible off your foot while wearing your cast. The more weight you put on your foot, the greater your chances of prolonging your healing time. If your fifth metatarsal does not heal properly, you are at risk of suffering complications, such as arthritis or a chronic limp. Though everyone heals at a slightly different pace, a typical recovery schedule after your foot is placed in a cast may go as follows:

   Two weeks – Return to your physician for X-rays. If you are having any problems with your cast, such as discomfort or numb toes, you should consult your physician.

   Four weeks – Return for more X-rays.

   Six weeks – More X-rays of your foot are taken and if your physician sees signs of healing, your cast may be removed.

   Eight weeks – X-rays typically show signs of healing and your cast is removed. Your foot may be put into a removable brace, called a cam walker, or into a weight bearing cast with a shoe on the bottom. You may need to continue to use crutches as you begin to bear weight. As pain decreases over the next four weeks, you will become less reliant on crutches.

   Twelve weeks – Your physician may take you out of the brace and return you to normal shoe wear. Your foot will be weak when it first comes out of the brace and your physician typically teaches you basic foot stretching exercises to perform at home.

   Sixteen weeks – With a proper stretching and strengthening regimen, you may be able to return to sports and activities without pain.

If your physician does not see signs of healing in the X-rays of your foot taken at eight weeks, you will have to decide how to proceed. Some patients may not show signs of healing for 10 to 14 weeks. You may opt to continue wearing the cast and using crutches for another four weeks to see if your fifth metatarsal heals. The other option is to undergo surgery, which can fix your fifth metatarsal bone in position and stimulate blood flow if your fifth metatarsal will not heal in a cast. If your foot heals on schedule, you ordinarily spend about four weeks stretching and strengthening your foot and ankle after you return to normal shoe wear.

Rehabilitation [top]

Most people do not need formal physical therapy to recover from a fifth metatarsal fracture treated in a cast. As your foot heals, you slowly graduate from the cast to the cam walker to normal shoe wear. 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 eight weeks after the injury while wearing your cam walker or walking cast. The key is to avoid pain. Do not walk distances that cause discomfort in your foot. 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 12 weeks to heal before you can return to normal shoe wear. Most patients can return to sports and activities about 16 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, talk with your physician before returning to activities, as you may need further treatment.

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.


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.

   Treatment Introduction
   Home Recovery
Closed Reduction and Internal Fixation

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