Metatarsal fracture (acute) - aftercare

The metatarsal bones are the long bones in your foot that connect your ankle to your toes. They also help you balance when you stand and walk.

A sudden blow or severe twist of your foot, or overuse, can cause a break, or acute (sudden) fracture, in one of the bones.

There are five metatarsal bones in your foot. The fifth metatarsal is the outer bone that connects to your little toe. It is the most commonly fractured metatarsal bone.

A common type of break in the part of your fifth metatarsal bone closest to the ankle is called a Jones fracture. This area of the bone has low blood flow. This makes healing difficult.

An avulsion fracture occurs when a tendon pulls a piece of bone away from the rest of the bone. An avulsion fracture on the fifth metatarsal bone is sometimes called a "dancer's fracture."

If your bones are still aligned (meaning that the broken ends meet), you will probably wear a cast or splint for 6 to 8 weeks.

• You may be told to not put weight on your foot. You will need crutches or other support to help you get around.
• You may also be fitted for a special shoe or boot that may allow you to bear weight.

If the bones are not aligned, you may need surgery. A bone doctor (orthopedic surgeon) will do your surgery. After surgery you will wear a cast for 6 to 8 weeks.

You can decrease swelling by:

• Resting and not putting weight on your foot
• Elevating your foot

Make an ice pack by putting ice in a plastic bag and wrapping a cloth around it.

• Do not put the bag of ice directly on your skin. Cold from the ice could damage your skin.
• Ice your foot for about 20 minutes every hour while awake for the first 48 hours, then 2 to 3 times a day.

For pain, you can use ibuprofen (Advil, Motrin, and others) or naproxen (Aleve, Naprosyn, and others).

• Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or more than your provider tells you to take.

As you recover, your provider will instruct you to begin moving your foot. This may be as soon as 3 weeks or as long 8 weeks after your injury.

When you restart an activity after a fracture, build up slowly. If your foot begins to hurt, stop and rest.

Some exercises you can do to help increase your foot mobility and strength are:

• Write the alphabet in the air or on the floor with your toes.
• Point your toes up and down, then spread them out and curl them up. Hold each position for a few seconds.
• Put a cloth on the floor. Use your toes to slowly pull the cloth toward you while you keep your heel on the floor.

As you recover, your provider will check how well your foot is healing. You will be told when you can:

• Stop using crutches
• Have your cast removed
• Start doing your normal activities again

Contact your provider if you have any of these symptoms:

• Swelling, pain, numbness, or tingling in your leg, ankle, or foot that becomes worse
• Your leg or foot turns purple
• Fever

Broken foot - metatarsal; Jones fracture; Dancer's fracture; Foot fracture

Bettin CC. Fractures and dislocations of the foot. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 89.

Kwon JY, Gitajn IL, Richter M,. Foot injuries. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 67.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.