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Metatarsal Madness

Author: Jeremy Swisher, MD
Peer-Reviewer: Justine Ko, MD, CAQ-SM
Final Editor: Alex Tomesch, MD, CAQ-SM

A 57-year-old female presented to the emergency department with complaints of severe pain in her right foot after twisting her ankle earlier today. She denies any numbness or tingling, but has had difficulty walking due to the pain.

Image 1. Plain oblique radiograph of the right foot. Author’s image.


[1] Smidt KP, Massey P. 5th Metatarsal Fracture. In: StatPearls. StatPearls Publishing; 2023. Accessed August 11, 2023. PMID: 31335089

[2] Hatch RL, Alsobrook JA, Clugston JR. Diagnosis and management of metatarsal fractures. Am Fam Physician. 2007;76(6):817-826. PMID: 17910296




Distal 5th Metatarsal Fractures

Jones Fracture

Metatarsal Bursitis

Fracture Location

Distal shaft of 5th metatarsal

Metadiaphyseal junction of 5th metatarsal

Soft tissue over metatarsal

Common Presentation

Twisting/jump-related, swelling, tenderness

Sudden activity-related pain, localized swelling

Swelling, tenderness, warmth

Diagnostic Imaging

X-ray (lateral to medial fracture line)

X-ray (perpendicular fracture line)

Clinical exam, ultrasound/MRI if needed


Non-operative, weight-bearing as tolerated

Non-weight-bearing/partial, possible surgery

Rest, NSAIDs, padding, address cause

Healing Time

6-8 weeks


Typically 3-6 weeks

Table 1. 5th Metatarsal Injuries [1,2]