Fifth Metatarsal FractureA Systematic Review of the Treatment of Fractures of the Base of the Fifth Metatarsal Bone. During an avulsion injury, a variable size fragment of bone at the base of the 5th metatarsal is pulled off by a strong plantar ligament that is attached to this part of the bone. Does not involve 4th-5th intertarsal junction. Hills Road, Cambridge The tuberosity avulsion fracture (also known as pseudo-Jones fracture or dancer's fracture [2] is a common fracture of the fifth metatarsal (the bone on the outside edge of the foot extending to the little toe). 2018 Sep-Oct;57(5):982-986. doi: 10.1053/j.jfas.2018.03.018. Ice should be applied for 20 minutes three to four times a day. Wear supportive footwear as recommended, this can be removed at night and resting. It is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension. For the first few weeks, they will have to significantly limit their walking and may need crutches. After the first 2 weeks, you should be able to start exercising your foot again. A complete clinical and radiological assessment is required to select the best treatment option. This fracture occurs when a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This avulsion injury usually is associated. A popping or cracking sound. The length of time it takes for an avulsion fracture of the fifth metatarsal to heal depends on many factors, such as age, weight, activity level, treatment received. In this type of injury, the tendon that attaches to the base of the fifth metatarsal may stretch and pull a fragment of bone away from the base. Epub 2020 May 30. Epub 2012 Mar 30. Avulsion fractures of the 5th metatarsal occur when the peroneus brevis tendon pulls on the base of the 5th metatarsal. Avulsion Fractures (pseudo-Jones Fractures) Fractures of the base of the metatarsal are often referred to as an avulsion fracture. Fracture at the base of the 5th metatarsal tubercle. This type of fracture is the result of an injury that causes your ankle to roll. In certain cases, the fracture may not heal and will continue to be painful for several months. A 5th metatarsal avulsion fracture is an injury that is usually treated non-operatively. Our results demonstrated that radiographic evidence of fracture healing was present in all patients by 65 days with 44 days representing the average elapsed time for such change. 1999 May 1;59(9):2516-22. The https:// ensures that you are connecting to the Avulsion fractures of the fifth metatarsal bone occur when a . Analysis of a fracture registry. In other circumstances, when a persons employment or recreation require a reliable and routine return by 4-6 weeks, surgery may also be indicated. In most instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing. Initial treatment of a metatarsal stress fracture includes rest, ice, and the use of an anti-inflammatory medication. The indication for surgical treatment of Jones' fractures depends on activity level and Torg classification: type I fractures are treated non-operatively. Avulsion fractures of the tuberosity are the most common fractures involving the proximal fifth metatarsal. b) As above, but bring your feet so they are touching toe to heel. When the ankle is twisted inwards a muscle called the peroneus brevis contracts to stop the movement and protect the ligaments of the ankle. Zone 1 (avulsion fracture): These fractures make up 93% of all fifth metatarsal fractures. It will be associated with quite specific local tenderness over the base of the bone, on the outside of the foot (the 5th metatarsal). The fifth metatarsal is the long thin bone that runs along the outside of the foot Occasionally a small piece/flake of bone may be pulled off where the ligament attaches to the bone if the foot is twisted inwards. If your discomfort lasts longer than two weeks, or if it is severe and accompanied by swelling or discoloration, consult a doctor. The fifth metatarsal is the long bone on the outside of the foot that connects to the . The present study focused on quantifying the time for healin Three-wire fixation technique for displaced fifth metatarsal base fractures. Clipboard, Search History, and several other advanced features are temporarily unavailable. Surgical treatment is indicated when the fracture is displaced more than 2mm or when more than 30% of the cubometatarsal joint is involved. Copyright 2020 - 2022 Stamina Comfort Inc. Can you walk on a broken fifth metatarsal? Segond fracture is an avulsion fracture associated with disruption of the ACL appears in 75% of ACL tear cases. Difficulty moving your limb. Two types of fractures that often occur in the fifth metatarsal are: Avulsion fracture. Clinical inquiries. Herterich V, Baumbach SF, Kaiser A, Bcker W, Polzer H. Dtsch Arztebl Int. Herterich V, Baumbach SF, Kaiser A, Bcker W, Polzer H. Dtsch Arztebl Int. CB2 0QQ, Telephone +44 (0)1223 245151 Metatarsal fractures are common in the paediatric population and rarely require operative management. The site is secure. Disclaimer, National Library of Medicine J Foot Ankle Surg. Contact your GP if your condition is not improving, or if your pain relief is not adequate. Everybody thinks there's a timeline, four weeks, six weeks, 12 weeks, six months, whatever. How long after metatarsal surgery can I walk? Avulsion fracture of the 5th metatarsal. Treated with walking cast for 3-6 wks. Confusion surrounding fracture terminology often compounds . How long does an avulsion fracture of the 5th metatarsal take to heal? Methods: Biomechanical test of stability of tension banding and screw fixation of fifth metatarsal avulsion fractures in cadaver specimen, sonographic measuring of the maximum cross-section of the peroneus brevis muscle, electromyographic examinations of the activity of the peroneus . Epub 2021 Sep 6. It may also make shoe shopping difficult because of the length of the bone. An avulsion fracture of the fifth metatarsal occurs where a tendon attaches to the bone at this point (the peroneus brevis tendon). Treatment involves relative rest and time to allow the fracture to heal. On exam, it is determined if the patient can still move their foot to the outside (eversion of the foot). 2022 Apr 5;11(4):e37171. Chun DI, Min TH, Cho JH, Won SH, Shon JI, Yi Y. J Bone Metab. There may be tenderness over a large area of the outside of the foot. If you experience any pain while walking, see your doctor immediately so that he/she can determine the cause and help you recover quickly. Swing your arms in a figure of eight in both directions for 1-2 minutes, or as able. In these cases, you might need surgery to repair the damage and allow the bone to heal correctly. Avulsion fracture of the 5th metatarsal styloid, also known as a pseudo-Jones fracture or a dancer fracture, is one of the more common foot avulsion injuries and accounts for over 90% of fractures of the base of the 5 th metatarsal. Functional outcome of 103 fractures of the proximal fifth metatarsal bone. How long does it take for a 5th metatarsal fracture to go away. MeSH The third thing is what you do to speed up the healing of that fracture after the surgery. Each bone consists of four parts- the base, shaft, neck and head. This site needs JavaScript to work properly. The .gov means its official. Displaced avulsions may take longer to heal, but do so with low rate of complications. There are 5 metacarpal bones and each metacarpal bone forms a connection between a finger and the wrist joint. Fifth Metatarsal FractureA Systematic Review of the Treatment of Fractures of the Base of the Fifth Metatarsal Bone. Help accessing this information in other formats is available. Drive whilst wearing the walking boot as you will void your insurance should you have an accident. Pflger P, Zyskowski M, Mller M, Kirchhoff C, Biberthaler P, Crnlein M. Eur J Med Res. Stage 2: For patients who would like to develop dynamic core control for sports. Allow your foot to relax completely, like hanging over the edge of a bed. Sx often mild, patients usually present with sprained ankle complaint. Xu YP, Xie LM, Xu C, Zhang Y, Li YB, Qiao X. Zhongguo Gu Shang. Avulsion Frx of Base of 5th Metatarsal. This includes walking on it too soon or placing any additional stress on it. Epub 2021 Sep 6. In these cases, the bone fragments are repositioned and stabilized with a screw and weight bearing may be started immediately. There are 5 types of 5th metatarsal fractures: [ Herrera-Soto, 2007 ] Fleck. The difference between a hard-to-heal fracture of the fifth metatarsal, the so-called . Avulsion fractures of the proximal fifth metatarsal are the most common type of fifth metatarsal fracture. Please enable it to take advantage of the complete set of features! It depends. Avulsion fractures are particularly commonplace in certain areas of the body such as the outside of the foot (at the 5th metatarsal bone). Treatment recommendations for fractures to the base of the fifth metatarsal (MTV) are still a matter of debate. An official website of the United States government. Avulsion may occur, especially at the base of the 5th metatarsal. Careers. Impact activity, such as running or sports can take up to 6 months for complete bone healing. However, they usually are able to perform the action though with decreased strength compared with the opposite side. Ficek K, Kdra N, Skowronek R, Kluczniok K, Strzik M, Gwiazdo P, Hajduk G. J Hum Kinet. INTRODUCTION Fractures of the proximal fifth metatarsal pose an important diagnostic challenge. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169. When there is complete displacement of the fracture fragments and union is unlikely, surgery is indicated. . Am Fam Physician. This will help it to heal faster. An official website of the United States government. Polzer H, Polzer S, Mutschler W, Prall WC. We conclude that a soft dressing allows patients to return to pre-injury levels of activity faster than when treated in a short leg cast and without compromising clinical or radiographic union of avulsion fractures of the base of the fifth metatarsal. Around four weeks following surgery, start with brief walks in your weight-bearing cast or can walker as pain allows. Avulsion fractures: Start with range of motion and progress to strengthening of the peroneus brevis (external rotation and pronation of the foot). However, there is no relevant report on the incidence, injury type and treatment principle of the fifth MBF combined with an LCAL injury. This twisting can result in either a foot avulsion fracture or an ankle avulsion fracture or possibly both. Pituckanotai K, Arirachakaran A, Piyapittayanun P, Tuchinda H, Peradhammanon E, Kongtharvonskul J. J Foot Ankle Surg. sharing sensitive information, make sure youre on a federal Use ice, wrapped in a tea towel and elevate your ankle to bring swelling down. 2022 Jan 11;7(1):13-25. doi: 10.1530/EOR-21-0025. 2012 Oct;43(10):1626-32. doi: 10.1016/j.injury.2012.03.010. An avulsion fracture is where a small chip of bone is pulled from the epiphysis (hence the name traction epiphysis). Epub 2021 Aug 31. The fifth metatarsal is the long thin bone that runs along the outside of the foot Occasionally a small piece/flake of bone may be pulled off where the ligament attaches to the bone if the foot is twisted inwards. A 5th metatarsal avulsion fracture may sometimes be referred to incorrectly as a pseudo-Jones fracture because of the resemblance to a Jones fracture and the common mechanism of injury. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal: a comparative cohort study. This site needs JavaScript to work properly. Also, the average modified foot score for patients treated in a soft dressing was 92 (excellent) compared to 86 (good) for patients treated in a short leg cast. It is important to see your doctor if you experience pain in your feet for more than two weeks, as this could be a sign of something more serious. Radiographic features Plain radiograph/CT Injury. Avulsion means "pulling or tearing away." In an avulsion fracture, the bone is pulled off the fifth metatarsal bone by a tendon or ligament. Please examine the image below to comprehend the location of this injury. After eight weeks, you may begin limited jogging. An avulsion fracture occurs when a small part of bone is torn off the big portion of the bone by a tendon or ligament. Surgical treatment is indicated when the fracture is displaced more than 2mm or when more than 30% of the cubometatarsal joint is involved. Careers. J Pediatr Orthop. Proximal fifth metatarsal fractures that are distal to the tuberosity have. Bethesda, MD 20894, Web Policies Before The Clinical Outcomes of Operative Treatment Versus Conservative Treatment for Dancer's Fractures: Protocol for a Retrospective Cohort Study. Muscle pain. Gently start to move ankle as pain allows. The fifth metatarsal is the long bone on the outside of the foot that starts in the middle of the foot and forms a joint with the pinky toe. Avulsion fractures are often caused by an. Rikken QGH, Dahmen J, Hagemeijer NC, Sierevelt IN, Kerkhoffs GMMJ, DiGiovanni CW. Swelling pain and bruising at the fracture site is normal. One of the most common sites for an avulsion fracture is at the base of . Take pain killers as needed to keep pain levels under control. Surgical Treatment. Mechanism The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion 5. A Jones fracture refers to a break between the base and shaft of the fifth metatarsal bone of the foot. Adequate union rates for the treatment of acute proximal fifth metatarsal fractures. After sudden, severe pain, the most common symptoms of avulsion fractures include: Bruising. An avulsion fracture of the base of the fifth metatarsal can occur if the ankle is twisted inwards. A Jones fracture is a small fracture on the 5th metatarsal in an area of limited blood supply. and transmitted securely. How long does it take for a broken ankle to stop hurting? Avulsion Fracture. Operative treatment usually is recom-mended for patients with a proximal diaphyseal fth metatarsal fracture. Previously Edited by David N. Garras, MD and Lance Silverman, MD, FootEducation LLC Accessibility Surgery may be needed if the bones are unacceptably separated, angulated, or displaced. The anatomy of all the metacarpal bones is the same. San Francisco CA 94123, a spiral fracture of the 5th metatarsal shaft that was originally described in Dancers, Did you know our resouces can be found in. The outcome of conservative treatment of fifth metatarsal diaphyseal fractures. Successful treatment of avulsion fractures of the base of the fifth metatarsal has been achieved using both short leg casts and soft (Jones) dressings. Avulsion fractures involving the knee are commonly a result of fall or sport injuries such as skiing, basketball and baseball. Knee Surg Sports Traumatol Arthrosc. The time frame for this will be discussed with you at the point of assessment. Avulsion fractures: An avulsion fracture on the 5th metatarsal bone is called a 'dancer's fracture' [64]. We conclude that a soft dressing allows patients to return to pre-injury levels of activity faster than when treated in a short leg cast and without compromising clinical or radiographic union of avulsion fractures of the base of the fifth metatarsal. As your discomfort subsides, you should gradually discontinue use of the supportive shoe over three to five weeks. J Am Acad Orthop Surg Glob Res Rev. The vast majority of avulsion fractures at the base of the fifth metatarsal (74%) and dancer's fractures (84%) occurred in women. Your doctor will evaluate your foot when you are standing as well as sitting. There are 3 distinct fracture patterns that affect the base of the fifth metatarsal. Unfortunately, the terminology and descriptions of these injuries remain confusing in the orthopedic literature. Would you like email updates of new search results? The doctor will first try to reduce the fracture by pushing down on the end of the bone with a tool. A twisting injury to the ankle and foot may cause an avulsion (pulling off) fracture of the base of the 5th metatarsal the bone that attaches the little toe to the midfoot (Figure 1). Also, patients who walk on hard surfaces without appropriate footwear can develop recurrent fractures due to a lack of proper blood flow to the bone. As a result of poor blood supply, it is slow to heal. Surgical treatment is indicated when the fracture is displaced more than 2 mm or when more than 30% of the cubometatarsal joint is involved. Type II fractures can be treated non-operatively or operatively, depending on patient activity level. The longer you go without treatment, the more serious the problem will be when you do visit a doctor. 2018 Mar;39(3):326-331. doi: 10.1177/1071100717751183. The sudden pull of the peroneus brevis muscles that occurs when rolling you ankle results in the fracture of the fifth metatarsal. Possible causes are missing evidence, various fracture classifications, and diverging definitions for the term "Jones fracture" [1,2,3,4].The most widely accepted classification was published by Lawrence and Botte [] (L&B) in 1993.. government site. An avulsion fracture can also occur with a sudden force applied to the 5th metatarsal bone. When the muscle contracts, your foot everts (turns outwards) and plantar flexes (points the foot down). The end of the fifth metatarsal bone feels like a bony prominence on the outside of your foot. You may be given a supportive boot to wear for up to six weeks. 2021 Jul 28;79:101-110. doi: 10.2478/hukin-2020-0059. This will prevent stiffness. Bryant T, Beck DM, Daniel JN, Pedowitz DI, Raikin SM. You can walk as much as your discomfort allows on your wounded foot. This will produce immediate pain over the outside aspect of the foot. There should be no flex in the muscles when you apply the tape. A 5th metatarsal avulsion fracture is often confused with a 5th metatarsal metadiaphyseal stress fracture (Jones fracture). An avulsion fracture of the 5th metatarsal happens at the end of the bone closest the ankle, the part of the bone attached to the tendon. Swelling. This type of fracture occurs in the little toe, closer to the ankle bone. 2. This generally takes 6 weeks to union (heal), yet discomfort and edema might last for 3-6 months. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. Studies have centered around classification systems, but debate continues regarding surgical versus conservative treatment modalities. The size of the fractured fragment may vary considerably. Here, a small piece of bone is pulled off the metatarsal by a tendon or ligament/fascia during a twisting injury of the foot or ankle. How are they classified? She's passionate about helping people live their best lives possible through healing and self-care practices. Avoid wearing high heels or tight shoes if you can as this will put stress on the bone which could cause it to break again. Of all foot fractures the fifth metatarsal fracture is the most common. Avulsions of the hand and wrist are a heterogeneous group of injuries, but they often have a characteristic imaging appearance that relates to the intricate bone and soft-tissue anatomy and the mechanism of injury. Often the base of the fifth metatarsal can be felt as a bump on . [1,2] The fracture of the proximal fifth metatarsal is not only owing to the direct injuries in this area, but also to the inverted injuries with plantar flexion. Clipboard, Search History, and several other advanced features are temporarily unavailable. Accessibility Pain that spreads to nearby parts of your body. . Frequently Asked Questions Can you walk on a metatarsal fracture? This type of fracture is not considered a true Jones fracture (also known as a "pseudo-jones"). These fractures typically are treated without surgery using a cast, boot, or hard-soled shoe and tend to heal within 6-8 weeks. 2021 Apr;29(4):1284-1293. doi: 10.1007/s00167-020-06072-8. In an avulsion fracture,a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. The Fifth Metatarsal Bone Fracture in Athletes - Modalities of Treatment Related to Agility in Soccer Players. Some clinicians refer to this type of fracture as a Dancers Fracture. However, more commonly a Dancers fracture is considered a spiral fracture of the 5th metatarsal shaft that was originally described in Dancers. HHS Vulnerability Disclosure, Help Most patients are able to run again between ten and 12 weeks following surgery. But there are always things that you can do to speed up the process. This type of injury needs to be differentiated from a Jones fracture,which occurs slightly further towards the center of the 5th metatarsal. Epidemiology Incidence frequent injury encountered in primary care setting base of 5th metatarsal fractures account for 25% of all metatarsal fractures 90% are zone 1 fractures Shahid MK, Punwar S, Boulind C, Bannister G. Foot Ankle Int. Types of a 5th Metatarsal Avulsion Fracture PMC Fifth metatarsal avulsion fractures are among the most common fractures seen by foot and ankle surgeons. a) Stand with one foot in front of the other, with your hands together. JMIR Res Protoc. [Case-control study on the treatmentof the fifth metatarsal base fractures by cardboard compression pad versus short leg plaster]. The fifth metatarsal bone is more commonly fractured. What is an avulsion fifth metatarsal fracture? Typically, patients are placed in awalking boot to immobilize the peroneus brevis tendon. Unable to load your collection due to an error, Unable to load your delegates due to an error. Beverly Giordano is a healthcare worker and has been in the industry for over 20 years. When an avulsion fracture occurs, the tendon pulls off a tiny fragment of bone. Sometimes, they are stress fractures that result from ankle rolls and repetitive stress. For more information please visit the Fracture information website. MyChart - Keeping you involved and informed about your care. You've suffered an avulsion fracture at the base of your fifth metatarsal. Often this is a very painful trauma that occurs with twisting, either inward or outward, to the ankle or foot. Most common fracture at base of 5th metatarsal. EFORT Open Rev. Please enable it to take advantage of the complete set of features! [4] After healing from surgery, your fifth metatarsal may feel weak until it has time to strengthen up. What is the most effective management of acute fractures of the base of the fifth metatarsal? While a regular fracture describes a break in the bone that tends to occur suddenly, and a stress fracture describes tiny hairline cracks that develop slowly over time, an avulsion fracture is one where the stress and tension from a tendon or ligament that is attached to a bone pulls of a piece off the bone, fracturing it. Herrera-Soto JA, Scherb M, Duffy MF, Albright JC. This type of fracture is sometimes called a "pseudo-Jones" fracture. The majority of fifth metatarsal base injuries recover without problems. However, it might take many months for your symptoms to entirely resolve. If you have severe pain when walking, try wearing shoes that add support under the ball of your foot. Federal government websites often end in .gov or .mil. doi: 10.2196/37171. The Jones fracture is known for prolonged healing time and non-union. A true Jones fracture is located about 1.5 -3 cm . PMC Epub 2011 Sep 10. 2011 Nov-Dec;50(6):776-9. doi: 10.1053/j.jfas.2011.07.009. Fractures of the proximal fifth metatarsal. An arguably more interesting finding occurred when fracture location was correlated with gender. The fifth metatarsal is the bone that runs from the midfoot to the base of the small toe on the outside of the foot. If the patient has the ability to actively move the foot outwards (eversion), the injury will likely heal with non-operative treatment. Materials and methods Take part in any physical/ contact sports which may put you at risk at further injury. Unlike a Dancers fracture, aJones fracture will more commonly fail to heal without surgery despite extended periods of non weight bearing. If the cause of your pain is identified and treated, most metatarsalgias will go away on their own. official website and that any information you provide is encrypted Would you like email updates of new search results? 269 Chestnut St. #271 Doing this usually creates some discomfort for the patient. Our strategy for a healthier life for everyone through care, learning and research. In this case, surgery would be required to remove any metal implants used during treatment. 2021. Bookshelf However, the main tenderness will be at the base of the 5th metatarsal. X-ray shows an avulsion fracture at the base of the fifth metatarsal (arrow). Your doctor may want to x-ray your foot to look for any underlying problems such as arthritis or infection. If you're suffering from pain after an avulsion fracture has healed, then you should see a doctor to ensure that no bone infection has occurred. Can a broken 5th metatarsal heal on its own? If the patient has the ability to actively move the foot outwards (eversion), the injury will likely heal with non-operative treatment. When an avulsion fracture occurs, the tendon pulls off a tiny fragment of bone. Association between Bone Mineral Density and Fracture Characteristics in the 5th Metatarsal Bone Base Fracture in Elderly for Prediction of Osteoporotic Fracture. The fifth metatarsal in the foot, which is the bone at the base of the little toe, can be vulnerable to avulsion fractures. [0:02:02] Fractures in this bone are denoted as 5th metacarpal fractures. Fifth Metatarsal Base Fracture Combined With Fracture of the Os Peroneum. The typical treatment for a fifth metatarsal fracture, including an avulsion fracture, is a nonsurgical, conservative - . A severe hamstring injury may also give rise to an avulsion fracture of the bone where it inserts into the pelvis & requires a lengthy rehabilitation process. If surgery is required, it's usually done along with repair of the associated ligament damage. Interestingly though, as time passed, a true dancer's fracture of the metaphyseal-diaphyseal junction appeared. The imaging appearance and this intricate form and function dictate treatment of hand and wrist avulsions . Immobilization. Significantly, the average length of recuperation for patients treated with a soft (jones) dressing was 33 days as compared to 46 days for those treated with a short leg cast. If your injury has occurred suddenly then you may either have a simple tear of the tendon. Without treatment, the pain from a broken fifth metatarsal could last for several weeks or longer. 5th Metatarsal Fractures: Location Matters. Difficulty with balance due to weakness of the peroneus brevis also occurs. In an avulsion fracture, a small piece of bone is pulled off the main portion of your bone by a tendon or ligament. A foot avulsion injury commonly occurs in the 5th metatarsal and is often referred to as a "dancer's fracture". 5th Metatarsal Base Fracture Accessory Navicular Achilles Tendon Problems Achilles Tendon Rupture Ankle Arthritis Ankle Fracture Ankle Lateral Ligament Injury Ankle Medial Ligament Injury Ankle Sprain Big Toe Arthritis (Hallux Rigidus) Bunion (Hallux Valgus) Bunionette Deformity (Tailor's Bunion) Calcaneocuboid Arthritis Calf Tightness A patient who suffers an acute rolling of their ankle can also injure the base of the 5th metatarsal (See Figure 1). More commonly, 5th metatarsal fractures occur from an injured foot, overuse, or high arches. Since the fragment is pulled away from the rest of the bone, this type of injury is called an avulsion fracture. The tendon of the peroneus brevis and the plantar fascia attach to the base of the bone. Fifth metatarsal fractures: an update on management, complications, and outcomes. Usually by 6 weeks, there is enough healing to allow them to transition to a stiff-soled shoewith lots of padding. The major muscle that controls lateral foot balance, the peroneus brevis, also attaches at the base of the 5th metatarsal and can be a source of increasing pain if not allowed to rest. A broken fifth metatarsal can cause pain and disability if it does not heal properly. - most often this frx is extra-articular, w/ the frx lying proximal to the metatarsocuboid joint; - commonly seen in dancers; - frx may be associated w . 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