The 3 Types of Fifth Metatarsal Fractures

The fifth metatarsal is the bone on the outside of the midfoot at the base of the small toe. The proximal end of the fifth metatarsal (proximal means closer to the center of the body) is easily felt as the bump over the outside part of the midfoot. This part of the fifth metatarsal bone is prone to injury. 

Illustration of a foot metatarsal fracture
Science Picture Co / Getty Images

The fifth metatarsal is the most commonly fractured of all the metatarsal bones.

Three primary types of fractures occur in the proximal fifth metatarsal, and all have different treatment implications. Like all other medical issues, not every fracture will fall perfectly into one of these three fracture types, but these categories are useful for treatment guidance.

Avulsion Fractures

Avulsion fractures occur when the tip of the bone is pulled off the fifth metatarsal by the tendon that attaches to this region.

Avulsion fractures tend to heal easily, and seldom require surgical treatment. 

Most often these injuries can be treated similarly to a ligament or tendon injury. Usually, a stiff-soled shoe, such as a cast shoe, is worn for a few weeks until the pain and swelling have subsided. Full healing takes 6-8 weeks.

Jones Fractures

Jones fractures occur in the metatarsal bone just beyond the avulsion fractures.

Jones fractures are more difficult to heal and often require immobilization (cast treatment), protection from weight (crutches), and may require surgery.  

If the injury is acute, meaning the diagnosis is made immediately following the injury, then non-surgical treatment is much more likely to be effective. A delayed diagnosis increases the likelihood of nonunion and the possible need for surgical treatment.

In athletes, sometimes surgical treatment is considered even in acute settings, just to ensure the healing process is predictable. Healing time of a Jones fracture is typically 12 weeks.

Stress Fractures

Stress fractures of the proximal fifth metatarsal are the hardest to heal and are more likely to require surgery.

These fractures often start with vague pain on the outside of the foot, often thought to be tendonitis. Over time, the stress fracture can become a complete break.

Because the body has a hard time healing these fractures, they require surgical treatment much more commonly. Healing time of a stress fracture also is typically at least 3 months.

A Word From Verywell

As stated before, not every fracture is clearly categorized into one of these fracture types. Determining the best treatment is dependent not only on the specific fracture pattern but also the patient's expectations for treatment.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ramponi DR. Proximal fifth metatarsal fractures. Adv Emerg Nurs J. 2013;35(4):287-92. doi:10.1097/TME.0b013e3182aa057b

  2. UpToDate. Proximal fifth metatarsal fractures. January 25, 2018.

Additional Reading
  • Dameron TB. Fractures of the Proximal Fifth Metatarsal: Selecting the Best Treatment Option. J Am Acad Orthop Surg. 1995;3(2):110-114.

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.