Foot & Ankle
5th Metatarsal Fracture
Non-Operative management
About Your Injury
This is a fracture at the base of the 5th metatarsal, the long bone on the outer edge of the foot leading to the little toe. It commonly occurs after twisting the ankle or foot, and is one of the most common foot fractures. Most of these avulsion-type fractures (Zone 1) heal reliably without surgery.
Non-Operative Management
5th metatarsal fractures can often be safely and effectively managed without surgery. The decision is individualised to each patient, based on patient factors (age, comorbidities, occupation) and specific characteristics of the fracture (fracture zone, displacement, blood supply).
Recovery Timeline
Weeks 0–2
Stiff-soled shoe or boot, weight-bearing as comfortable, swelling control.
Weeks 2–6
Gradual increase in activity as pain allows, physiotherapy-led from 2 weeks onwards.
Weeks 4–6
Transition to a comfortable, sensible jogger.
6–8 weeks
Return to normal footwear and most activities once comfortable.
3 months
Return to sport once pain-free and confident on the foot.
Follow-Up Schedule
2 weeks
Clinical review of pain and mobility — physiotherapy typically commences from here.
6 weeks
X-ray only if there is significant ongoing discomfort.
Discharge
Once pain-free and walking normally, or earlier review if concerns arise.
A Note on X-Ray Healing
Many of these fractures go on to heal with an asymptomatic fibrous nonunion, in which the bone heals with stable scar tissue instead of calcified bone. Functionally these are identical if you are pain free. This is often picked up on future imaging, sometimes for unrelated reasons or injuries — rest assured if it is asymptomatic, it is not a problem and does not require orthopaedic review. It is your symptoms, not the X-ray appearance, that guide the need for any further intervention — as such, X-rays after the 2-week mark are usually optional.