There are 26 bones in each of the human feet; 52 altogether. Given those numbers, there are plenty of locations for a broken bone and with the active lifestyles we lead, fractures of the feet are very common.
One of the more frequent fractures (another term for a broken bone) is that of the 5th metatarsal. The metatarsals are the long bones, just behind the toes that make up the middle of the foot, the arch. The 5th metatarsal is the one behind your little toe.
Frequently, this bone is broken in a twisting injury, such as in an ankle sprain, usually resulting in a break right at the end of the bone. Other times, it is a higher velocity injury that results in the break usually further up the bone. What it takes to heal the bone depends on the location of the break. If it is near the end of the bone it may be from a pull of a muscle when the twisting occurs, so making sure that the muscle stops pulling on it is important. If the break is across the bone, a bit further up, it is known as a “Jones” fracture. Either one may require surgery to help it heal.
A Jones fracture occurs in an area we call a “watershed” location; that means an area that has a normally reduced blood supply and that can be a problem. Reduced blood supply frequently causes a delay in the healing of the bone. Because of this (in most cases) in an active patient, surgical repair should be considered. Stability of the bone achieved in surgery typically allows more rapid healing, a faster return to activity and a reduced risk of a re-fracture (which is actually not uncommon).
Jones fractures have been a cause of some professional athlete retirements, as constant re-injury never allows the bone to become fully functional in its support of the foot and the body.
What to do? As with any injury, proper evaluation and diagnosis is necessary. X-ray and sometimes even a CT scan evaluation is warranted, particularly if surgery is anticipated and if there is a great deal of separation of the bone pieces, they must be put back in place as well as possible.
With or without surgery plan for a period of no weight on the foot for 4-6 weeks and in particularly difficult cases, 12-16 weeks may be required. Bone grafting and the use of electrical bone growth stimulators may be needed as well.
