Fracture of the Proximal Fifth Metatarsal

Acute fracture and nonunion of the proximal fifth metatarsal are difficult injuries to manage. The ability to distinguish the three distinct fracture patterns (ie, tuberosity, Jones, diaphyseal stress) is important because each has its own mechanism of injury, location, treatment options, and prognosis for healing. Tuberosity fractures, true acute Jones fractures, and Torg type I diaphyseal stress fractures have a high rate of union with nonsurgical management. However, primary surgical intervention with an intramedullary screw andJor inlay corticocancellous bone graft is the preferred treatment for acute Jones fracture in the athlete, delayedunion or nonunion of Jones fracture in the nonathlete and athlete, and Torg type II and III fracture14. Copyright 2009 by the American Academy of Orthopaedic Surgeons.