![]() ![]() The peroneus brevis inserts over a relatively large area on the dorsolateral aspect of the tuberosity. Although there are individual anatomic variations, the tuberosity usually protrudes downward and laterally beyond the margin of the diaphysis and the adjacent cuboid. At its proximal end, the fifth metatarsal articulates at the cuboid-fourth metatarsal joint, the cuboid-fifth metatarsal joint, and the 4-5 intermetatarsal joint. 9 The tuberosity has also been referred to as the styloid process of the metatarsal. Surgery may also be indicated for displaced or intra-articular fractures.Īnatomy of the fifth metatarsal: The fifth metatarsal consists of a head, neck, shaft, tuberosity, and base (Figure 2). Surgical treatment may be required for certain proximal fifth metatarsal fractures to speed recovery time or to salvage delayed unions or nonunions. These injuries must be distinguished from injury to the sesamoid (os peroneum, os vesalianum) and tarsometatarsal complex, which can also commonly cause pain in the dorsolateral, proximal forefoot.Īs varied as these fractures are, most fifth metatarsal fractures heal with immobilization. 19,20,22 Also occurring in this area in the immature foot are apophyseal distraction types of fifth metatarsal fractures. 9,19We will consider the fifth metatarsal tuberosity avulsion fracture (Figure 1a), the (acute) Jones fracture (Figure 1b), and the proximal diaphyseal stress fracture (Figure 1c), which has been described as having three subtypes (See Table 1). There are at least three, and probably six fracture types, that occur with any degree of frequency in the proximal fifth metatarsal. Fractures of the Proximal Fifth Metatarsal ![]() A practical treatment algorithm for fractures of the fifth metatarsal is offered to hopefully minimize future misunderstanding with regard to patient treatment. A series of fifth metatarsal fractures and treatment with results and followup examination will be presented. We will propose a classification scheme for fractures of the fifth metatarsal and give some historical – as well as practical – detail with regard to the treatment of each fracture type. This chapter will serve as an overview of proximal fifth metatarsal fractures, covering the etiology, mechanisms of injury, and the pertinent anatomy of this injury. There also is debate regarding the rate of reinjury of the proximal one-third of the fifth metatarsal. 1-11,13-20,22,23 Controversy regarding treatment of fractures in this area centers around whether the treatment should be closed or open, primary or delayed, whether the fracture should be bone grafted or fixed with an intramedullary screw or other internal fixation device, and whether the athlete should be treated any differently initially than the more sedentary person sustaining the same fracture. The orthopaedic literature is replete with articles distinguishing between fractures of the tuberosity of the fifth metatarsal, those of the metaphysis, and those at the metaphyseal-diaphyseal junction. 1,2,6,8,9,13,18,28 With regard to fractures of the proximal diaphysis of the fifth metatarsal, controversies exist regarding the importance of the acuity or chronicity of prodromal symptoms, the incidence and potential cause of delayed unions and nonunions of this portion of the bone, as well as determining the most optimal method of treatment. Controversies in diagnosing and classifying fractures of the proximal one-third of the fifth metatarsal are common, and have been perpetuated by a rather lax usage of anatomic terms and applications of eponyms such as the Jones fracture. Most of the controversy regarding fractures of the fifth metatarsal relates to those injuries sustained in the proximal one-third of the bone. X-Rays Our centers are equipped with a state-of-the-art digital X-ray machine.Sports Medicine Get back in the game with help from our sports medicine specialists.Sports Injury Urgent Care We offer same- and next-day care to patients with acute injuries.Podiatry We provide comprehensive, conservative care for a wide variety of foot and ankle conditions.Physical Therapy Our physical therapists use advanced techniques to help restore strength and mobility.Pain Management We take a unique, multidisciplinary approach to pain management.Orthopedic Surgery Providing the latest advances in orthopedic surgery is our specialty.MRI Our patients can receive MRI imaging onsite at both our Louisville and New Albany Clinics. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |