Management of Avulsion Fractures at the Base of the Fifth Metatarsal Bone

Sidney N. Eichenholtz, MD
JAMA. 1963;184(3):236-237. doi:10.1001/jama.1963.73700160007021.
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FRACTURES at the base of the fifth metatarsal bone occur most often as a result of twisting injuries to the foot, and are frequently mistaken for sprains unless adequate x-ray studies are made. These injuries are seen with sufficient frequency by general practitioners to warrant a brief consideration of practical management. They occur in all ages from 10 to 70. The patient hobbles into the office or clinic with a painful swollen foot on which he cannot bear weight without increasing pain. The author has seen a large number of these injuries and has used a simple, practical program of treatment.

Mechanism of Injury  A sudden twisting of the forefoot applies a supinator force resulting in a rupture of the lateral interosseus ligament between the cuboid and fifth metatarsal base. The attachment of the peroneus brevis tendon is torn loose carrying with it a portion of the bone. Usually there


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