Outside foot pain/Metatarsal #5 stress fracture?

The picture above is from the website www.healio.com

What does one do if they have pain on the outside of the foot? It could be a 5th metatarsal stress fracture. How does this occur?

It usually occurs with long distance runners and repetitive stress and trauma to the outside of foot. What is the evidence to treat this condition?

Less-active patients should be non-weight bearing in a short-leg cast for 6-8 weeks or until there is radiographic evidence of healing. If an established nonunion develops, screw fixation and/or bone grafting may be required. Weinfeld SB, Haddad SL, Myerson MS. Metatarsal stress fractures. Clin Sports Med. 1997 Apr. 16(2):319-38. [Medline].

Short Leg Cast w/ Toe Plate (Plaster) – YouTubewww.youtube.com

Image result for image of short leg cast



For active patients, early intramedullary screw fixation, with or without bone grafting, is often recommended. Tsukada S, Ikeda H, Seki Y, Shimaya M, Hoshino A, Niga S. Intramedullary screw fixation with bone autografting to treat proximal fifth metatarsal metaphyseal-diaphyseal fracture in athletes: a case series.Sports Med Arthrosc Rehabil Ther Technol. 2012 Jul 20. 4(1):25. [Medline]. [Full Text].


Image result for 5th metatarsal intramedullary screw image

If the stress fracture is not rested and a cast is not used, or if the physician reports that a screw is needed to fixate the bone and it is not treated the bone could keep on slipping out of place and a non union fracture could occur. If this occurs the bone could continually hurt and not heal.


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