Fifth metatarsal fractures

Clinical features

Most patients will have a clear history of trauma, usually a twisting injury. Athletes presenting with increasing pain, often with a further marked increase that precipitates presentation, should be suspected of having a stress fracture.

Examination will show local tenderness.

Imaging

For midfoot injuries the standard radiographs are AP, lateral and oblique. The oblique view shows the TMT joints and also shows the relationship between the fracture line and the 4:5 joint most clearly. Other imaging techniques are unlikely to be required.