Management of Fifth Metatarsal Fracture and Refracture in Athletes

Fractures of the proximal fifth metatarsal are very common in active individuals and elite athletes. Fractures may occur from a number of mechanisms, but inversion and twisting injuries are some of the most common causes. True Jones fractures are at the metaphyseal-diaphyseal junction and enter the fourth-fifth intermetatarsal articulation. Fractures in that area are at risk of delayed union or non-union, which can be extremely detrimental in elite athletes, because of the poor blood supply which results in a watershed area. Treatment recommendations depend on fracture location and acuity, as well as patient factors. Non-operative management can be successful, however delayed union and non-union may occur. Surgical stabilization of true Jones fractures is recommended in athletes and results in a low number of complications and a higher and more rapid rate of union much compared to non-operative methods. Overall, the treatment methods of fifth metatarsal fractures depend on a multitude of factors, however athletes benefit from more aggressive treatment regimens that result in high rates of union in less time.