Foot Case 2 ED Management

Fracture of the 5th metatarsal

Diaphyseal (or "metatarsal") fractures, if managed conservatively, have a high incidence of delayed union and malunion and require early orthopedic consultation. Many are managed operatively and require lengthy treatment.

Fractures at or proximal to the tubersosity are typically nonoperative avulsion fractures. Extra-articular tuberosity fractures will heal well requiring a walking cast or stiff shoe for approximately 2-3 weeks. Nondisplaced intraarticular fractures are treated with non-weight-bearing casting for 6-8 weeks with orthopedic evaluation one week from the ED visit. If the articular surface involved in tuberosity fractures is greater than 30% or displaced >2mm, fixation may be necessary and orthopedics should be involved early.