5th Metatarsal Avulsion Fracture

Often referred to as a 'Dancer's fracture,' an avulsion fracture to the 5th MT (metatarsal) affects the bone that connects the little toe to the main body of the foot. An avulsion fracture involves a fragment of bone being pulled off. This injury is different from a 5th MT stress fracture, which strikes further along the 5th metatarsal and is rarely connected to trauma (see our article for further details).

Symptoms of a 5th MT Avulsion Fracture

Localised pain in the area around the outside of the small toe, which can be debilitating and greatly interfere with your ability to walk. Exercising or weight bearing on the injured foot will exacerbate the pain. Another common symptom is accompanying inflammation around the small toe. This swelling can be severe and in the days after the fracture arises, the skin around the injury regularly becomes black and blue or bruised looking. The area will be tender to touch at the base of the 5th metatarsal.

Causes of 5th Metatarsal Avulsion Fracture

The name 'Dancer's fracture' was coined due to the high incidence of the injury in relation to stepping on a dancing partner's foot. A blow of this sort can also occur in contact sports like football or rugby, and the fracture is also associated with twisting injuries to the foot and ankle which can arise in many sports. The injured party often reports a history of ankle sprains or similar injuries, suggesting that the 5th MT has been weakened over time as a result of wearing down sustained through multiple injuries. The mechanism of the injury involves a huge pulling force from a powerful tendon on the outside of the foot, which is forced into yanking a fragment of bone from the metatarsal.

Medical Treatment for 5th Metatarsal Avulsion Fracture

Usually there is no need for surgery; the doctor can use a cast or other method to hold the injured foot in place while the fracture recovers. This takes approximately 6 weeks of total immobilisation but time varies depending on severity. You will need to rest and refrain from much walking until the doctor says otherwise. Pain medication can relieve the symptoms. When the doctor gives approval you can begin to gradually build your activity level, starting slowly by stretching and strengthening the rigid muscles in the affected foot. A physical therapist will be able to assist with recommending suitable training and guiding you at the correct speed. Full recovery may take up to 3 or 4 months, but this is essential for regaining total strength and control in the region and for minimising the chances of further injury.

Prevention of 5th Metatarsal Avulsion Fracture

Carefulness and awareness of your surroundings is important in terms of anticipating when somebody might accidentally step on your foot or in avoiding obstacles that could provoke ankle twisting. It is always beneficial to strengthen your ankles as much as possible and to rest during activity if you are feeling tired. Shoes with appropriate ankle support are invaluable.

Sports medicine

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