Diaphyseal fractures of the 5th metatarsal

These injuries include all fractures of the diaphysis of the 5th metatarsal.

They are classified as follows: 

• Simple diaphyseal fractures (AO/OTA 87.5.2A)
• Wedge diaphyseal fractures (AO/OTA 87.5.2B)
• Multifragmentary diaphyseal fractures (AO/OTA 87.5.2C)

The patient describes an acute trauma with immediate pain and difficulty in weight bearing. The foot progressively exhibits swelling and ecchymosis. The damaged area is very painful to palpation.

Deformities may not be appreciated.

Open fractures will have draining wounds.

Conventional radiographs of the foot (AP and lateral oblique views) are sufficient for diagnosis and treatment.

These fractures are typically caused by low energy torsion mechanisms.

High energy mechanism injuries are often associated with midfoot instability (Lisfranc instability).