There will be gapping at the fracture and there may be some shortening or rotation of the fracture (Figures 3A-3B). The usual fracture pattern is a spiral running from the outside aspect of the bone (distal lateral) near the toes to the inside aspect of the bone near the ankle (proximal medial). The size of the fractured fragment may vary considerably. X-rays of the foot will reveal a long oblique fracture of the shaft of the 5th metatarsal. However, the main tenderness will usually be just before the base of the fifth toe. There may be tenderness and swelling over a large area of the outside of the foot. When pressing on the outside of the foot, there will be marked tenderness over the 5th metatarsal. Figure 2: Twisting mechanism causing injury It will be associated with quite specific local tenderness over the bone near the base of the fifth toe and on the outside of the foot (the 5th metatarsal). Over time, the skin can turn black and blue. Weight bearing on the injured foot may be difficult due to pain and discomfort. It can be associated with significant swelling. This will produce immediate pain over the outside aspect of the foot near the toes. An acute rolling of their ankle while pointing the toes down can also fracture the shaft of the 5th metatarsal (See Figure 1). Figure 1: 5th Metatarsal Shaft “Dancer’s” FractureĪ patient who suffers a 5 th shaft fracture (See Figure 1) commonly gives a history of a twisting injury to their ankle and foot (inversion and plantarflexion injury), similar to what occurs with an ankle sprain (Figure 2). However, since this fracture of the fifth metatarsal was first described in ballet dancer’s, it has become known as a dancer’s fracture as well. **There is another fracture that may also be referred to as a dancer’s fracture. It often takes 4 or more months for a full recovery to occur. It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level. In many instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing. This 5th metatarsal “Dancer’s” fracture causes localized pain, swelling, and difficulty walking. During this injury, the 5th metatarsal is twisted by a strong force resulting in a spiral fracture. You can gain them back in the affected limb through exercise and various other treatments.A twisting injury to the ankle and foot may cause a long fracture of the 5th metatarsal shaft - the bone that attaches the little toe to the midfoot (Figure 1). Because of wearing a cast, you’ll likely lose some strength and range of motion. Physical therapy can be another important part of healing your fracture. As a result, acetaminophen with codeine is more commonly prescribed. Ibuprofen (Advil) and other nonsteroidal anti-inflammatory drugs have been shown to slow down the healing process. It will be removed after a period of a few weeks.Įspecially in the case of surgery, recovery can be rather painful. Recovery from surgeryĪfter an open reduction surgery, a cast is usually applied to the limb. Your doctor then realigns the broken bone and sets it in place with either rods, pins, or screws, all of which can be permanent or temporary. For example, if there is damage to the surrounding muscles or blood vessels, your doctor also evaluates and treat these injuries. Next, your doctor opens up the affected area to set the parts of the bone in place.ĭuring the operation, your doctor continues to assess the severity of the injury. In this procedure, you are put under general anesthesia. Your doctor will perform what is known as an open reduction surgery. Treatment for a displaced spiral fractureīecause of the jagged bones that characterize a displaced spiral fracture, more often than not surgery is required for treatment. A stable fracture is generally more common in children. If the spiral fracture is stable, treatment will usually involve keeping the bone immobilized with a cast for a period of four to six weeks. For these reasons, treatment will depend on the severity of the break and whether the bone is displaced or stable. It’s also possible that the injury results in detached bone fragments, which can make treatment even more difficult. Because of the way in which a spiral fracture occurs, the resulting broken bone usually has jagged edges.
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